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General NPI Number Information
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NPI Number | 1134991763
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Entity Type | Organization
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Legal Business Name | SUNSHINE RESIDENTIAL LLC
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Dates
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Enumeration Date | 10/26/2023
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Last Update Date | 10/26/2023
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Provider Practice Location Address
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Address Line | 5113 WARWICK RD
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City | RICHMOND
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State | VA
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Zip | 23224-2910
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Country | US
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Telephone | 434-568-0129
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Fax |
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Provider Business Mailing Address
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Address Line | 9830 BRAFFERTON RD
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City | MIDLOTHIAN
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State | VA
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Zip | 23112-1693
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Country | US
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Telephone | 434-568-0129
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | TANYA WATKINS
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Credential |
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Telephone | 434-568-0129
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251C00000X
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Taxonomy Name | Developmentally Disabled Services Day Training Agency
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License Number |
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License Number State |
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