Healthcare Provider Details

I. General information

NPI: 1760394761
Provider Name (Legal Business Name): SUNFLOWER DEVELOPMENTAL SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/22/2026
Last Update Date: 09/30/2026
Certification Date: 09/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10505 HALBRENT AVE
MISSION HILLS CA
91345-2019
US

IV. Provider business mailing address

10505 HALBRENT AVE
MISSION HILLS CA
91345-2019
US

V. Phone/Fax

Practice location:
  • Phone: 347-409-0586
  • Fax:
Mailing address:
  • Phone: 747-306-5610
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number StateNULL
# 4
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number StateNULL
# 5
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateNULL

VIII. Authorized Official

Name: NICOLETTA SKLAVOUNAKIS
Title or Position: SHAREHOLDER
Credential: LMSW, LBA, BCBA, IBA
Phone: 747-306-5610