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General NPI Number Information
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NPI Number | 1558160440
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Entity Type | Organization
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Legal Business Name | SUNSHINE COMMUNITY CARE CENTER LLC
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Dates
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Enumeration Date | 03/12/2025
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Last Update Date | 04/23/2025
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Provider Practice Location Address
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Address Line | 191 E BARSTOW AVE
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City | FRESNO
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State | CA
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Zip | 93710-5003
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Country | US
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Telephone | 559-375-1058
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Fax |
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Provider Business Mailing Address
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Address Line | 5108 E CLINTON WAY STE 107
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City | FRESNO
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State | CA
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Zip | 93727-2043
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CHIEF CAREGIVING OFFICER
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Name | PA VUE
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Credential |
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Telephone | 559-375-1058
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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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 | 251K00000X
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Taxonomy Name | Public Health or Welfare Agency
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 261QV0200X
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Taxonomy Name | VA Clinic/Center
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 332U00000X
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Taxonomy Name | Home Delivered Meals
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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