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General NPI Number Information
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NPI Number | 1447863923
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Entity Type | Organization
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Legal Business Name | SUNSHINE COMMUNITY HEALTH AND WELLNESS OUTREACH CENTER
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Dates
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Enumeration Date | 08/25/2020
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Last Update Date | 08/25/2020
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Provider Practice Location Address
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Address Line | 1817 W VIRGINIA AVE NE
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City | WASHINGTON
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State | DC
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Zip | 20002-1827
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Country | US
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Telephone | 202-878-6128
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Fax | 202-878-6102
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Provider Business Mailing Address
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Address Line | 1100 48TH PL NE
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City | WASHINGTON
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State | DC
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Zip | 20019-3914
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Country | US
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Telephone | 202-905-7581
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MS. NIA S EATMON
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Credential | RN
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Telephone | 202-878-6128
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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