=====================================================
General NPI Number Information
=====================================================
NPI Number | 1184435646
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | SUNNYSIDE BEHAVIORAL HEALTH CORP
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/15/2025
-----------------------------------------------------
Last Update Date | 02/01/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 370 MAIN ST
-----------------------------------------------------
City | WORCESTER
-----------------------------------------------------
State | MA
-----------------------------------------------------
Zip | 01608-1723
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 305-713-8093
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3275 DUNNING DR
-----------------------------------------------------
City | ROYAL PALM BEACH
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33411-8317
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 305-713-8093
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | BRUNA OROZ FOGLIANO
-----------------------------------------------------
Credential | BCBA LBA
-----------------------------------------------------
Telephone | 305-713-8093
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 106S00000X
-----------------------------------------------------
Taxonomy Name | Behavior Technician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 103K00000X
-----------------------------------------------------
Taxonomy Name | Behavior Analyst
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------