Healthcare Provider Details

I. General information

NPI: 1437714441
Provider Name (Legal Business Name): SUN SHINE THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/06/2019
Last Update Date: 08/28/2024
Certification Date: 08/28/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 STATE AVE
ALAMOSA CO
81101-2637
US

IV. Provider business mailing address

PO BOX 1191
ALAMOSA CO
81101-1191
US

V. Phone/Fax

Practice location:
  • Phone: 720-378-2231
  • Fax:
Mailing address:
  • Phone: 720-378-2231
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: VALERIE GURULE-DURAN
Title or Position: OWNER
Credential: LPC CAS
Phone: 720-378-2231