Healthcare Provider Details

I. General information

NPI: 1619592599
Provider Name (Legal Business Name): SUNNY SKIES HOMECARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/16/2020
Last Update Date: 06/16/2020
Certification Date: 06/16/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1973 LINDEN DR
BIRMINGHAM AL
35214-4857
US

IV. Provider business mailing address

1973 LINDEN DR
BIRMINGHAM AL
35214-4857
US

V. Phone/Fax

Practice location:
  • Phone: 205-617-5100
  • Fax:
Mailing address:
  • Phone: 205-617-5100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174200000X
TaxonomyMeals Provider
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: TIFFANY HAYES
Title or Position: OWNER
Credential:
Phone: 205-617-5100