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General NPI Number Information
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NPI Number | 1174000830
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Entity Type | Organization
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Legal Business Name | SUNSHINE BEHAVIORAL HEALTH GROUP
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Dates
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Enumeration Date | 07/25/2018
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Last Update Date | 12/17/2024
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Provider Practice Location Address
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Address Line | 17975 SKY PARK CIR STE B
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City | IRVINE
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State | CA
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Zip | 92614-6330
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Country | US
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Telephone | 719-602-3268
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Fax |
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Provider Business Mailing Address
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Address Line | DEPT #880624 PO BOX 29650
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City | PHOENIX
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State | AZ
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Zip | 85038-9650
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Country | US
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Telephone | 949-835-4369
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Fax |
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Authorized Official
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Title or Position | DIRECTOR OF COMPLIANCE AND REGULATO
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Name | STEPHEN VANHOOSER
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Credential |
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Telephone | 949-750-2014
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number |
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License Number State |
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