Healthcare Provider Details

I. General information

NPI: 1649317736
Provider Name (Legal Business Name): SUNNY ENTERPRISE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/30/2007
Last Update Date: 08/19/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8700 WESTPORT RD # SU112
LOUISVILLE KY
40242-3100
US

IV. Provider business mailing address

8700 WESTPORT RD SUITE #112
LOU KY
40242
US

V. Phone/Fax

Practice location:
  • Phone: 502-425-4726
  • Fax: 502-425-7560
Mailing address:
  • Phone: 502-425-4726
  • Fax: 502-425-7560

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code305R00000X
TaxonomyPreferred Provider Organization
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code385HR2060X
TaxonomyChild Intellectual and/or Developmental Disabilities Respite Care
License Number
License Number State

VIII. Authorized Official

Name: CURTIS WIGGINS
Title or Position: OWNER
Credential:
Phone: 502-425-4726