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General NPI Number Information
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NPI Number | 1740079334
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Entity Type | Organization
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Legal Business Name | SUNSHINE COMMUNITY HOMES, LLC
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Dates
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Enumeration Date | 05/01/2025
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Last Update Date | 05/01/2025
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Provider Practice Location Address
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Address Line | 1417 NW 21ST CT
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City | CAPE CORAL
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State | FL
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Zip | 33993-5978
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Country | US
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Telephone | 815-693-2896
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Fax |
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Provider Business Mailing Address
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Address Line | 2451 NW 21ST TER
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City | CAPE CORAL
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State | FL
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Zip | 33993-3771
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Country | US
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Telephone | 815-693-2896
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | BETH PECKHAM
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Credential |
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Telephone | 815-693-2896
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320600000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Residential Treatment Facility
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License Number |
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License Number State |
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