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General NPI Number Information
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NPI Number | 1467670232
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Entity Type | Organization
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Legal Business Name | SUNSHINE VILLAGE, INC
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Dates
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Enumeration Date | 04/24/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 54 SUFFOLK ST
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City | HOLYOKE
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State | MA
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Zip | 01040-5029
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Country | US
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Telephone | 413-535-3144
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Fax | 413-538-9463
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Provider Business Mailing Address
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Address Line | 75 LITWIN LN
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City | CHICOPEE
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State | MA
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Zip | 01020-4817
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Country | US
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Telephone | 413-592-6142
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Fax | 413-598-0478
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Authorized Official
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Title or Position | CHIEF FINANCIAL OFFICER
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Name | MR. SUDHAKAR VAMATHEVAN
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Credential |
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Telephone | 413-592-6142
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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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