Healthcare Provider Details

I. General information

NPI: 1144555913
Provider Name (Legal Business Name): SUNSHINE INC. RESIDENTIAL AND SUPPORT SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/12/2009
Last Update Date: 10/12/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5415 W BANCROFT ST
TOLEDO OH
43615-2823
US

IV. Provider business mailing address

7223 MAUMEE WESTERN RD
MAUMEE OH
43537-9755
US

V. Phone/Fax

Practice location:
  • Phone: 419-865-0251
  • Fax: 419-865-5607
Mailing address:
  • Phone: 419-865-0251
  • Fax: 419-865-5607

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number StateOH

VIII. Authorized Official

Name: MRS. RHONDA HELEN REGENT
Title or Position: ASSOCIATE DIRECTOR OF FINANCE
Credential:
Phone: 419-794-1371