Healthcare Provider Details

I. General information

NPI: 1598536021
Provider Name (Legal Business Name): SUNSHINE HOME CHORE PROVIDER SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/12/2024
Last Update Date: 01/12/2024
Certification Date: 01/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30600 TELEGRAPH RD STE 3140
BINGHAM FARMS MI
48025-5730
US

IV. Provider business mailing address

30600 TELEGRAPH RD STE 3140
BINGHAM FARMS MI
48025-5730
US

V. Phone/Fax

Practice location:
  • Phone: 248-499-4614
  • Fax:
Mailing address:
  • Phone: 248-499-4614
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number State

VIII. Authorized Official

Name: ANIAH DAVIS
Title or Position: ADMINISTRATOR
Credential:
Phone: 248-499-4614