Healthcare Provider Details

I. General information

NPI: 1154207967
Provider Name (Legal Business Name): SUNSHINE BEHAVIORAL SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/15/2025
Last Update Date: 09/12/2025
Certification Date: 09/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1351 DUKES CREEK DR NW
KENNESAW GA
30152-8232
US

IV. Provider business mailing address

1351 DUKES CREEK DR NW
KENNESAW GA
30152-8232
US

V. Phone/Fax

Practice location:
  • Phone: 850-980-7979
  • Fax:
Mailing address:
  • Phone: 850-980-7979
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code302R00000X
TaxonomyHealth Maintenance Organization
License Number
License Number State

VIII. Authorized Official

Name: MR. GATAVIUS PRICE
Title or Position: CEO/FOUNDER/CLINICAL DIRECTOR
Credential: MPH, BCBA
Phone: 404-500-7330