Healthcare Provider Details

I. General information

NPI: 1760229504
Provider Name (Legal Business Name): SUNSHINE COMMUNITY CARE CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/10/2024
Last Update Date: 01/08/2025
Certification Date: 01/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5108 E CLINTON WAY
FRESNO CA
93727-2043
US

IV. Provider business mailing address

2705 N CARRIAGE AVE
FRESNO CA
93727-0957
US

V. Phone/Fax

Practice location:
  • Phone: 559-375-1058
  • Fax: 559-520-4819
Mailing address:
  • Phone: 559-478-3736
  • Fax: 559-520-4819

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: PA VUE
Title or Position: ADMINISTRATOR
Credential: RN
Phone: 559-478-3736