Healthcare Provider Details

I. General information

NPI: 1497616296
Provider Name (Legal Business Name): SUNSHINE HORIZONS TRANFORMATION & WELLNESS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/20/2025
Last Update Date: 11/20/2025
Certification Date: 11/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3724 PHEASANT RUN DR
CHESTER VA
23831-7059
US

IV. Provider business mailing address

3724 PHEASANT RUN DR
CHESTER VA
23831-7059
US

V. Phone/Fax

Practice location:
  • Phone: 804-940-4077
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: AJAH TANN
Title or Position: OWNERR
Credential:
Phone: 804-940-4077