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General NPI Number Information
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NPI Number | 1780921684
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Entity Type | Organization
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Legal Business Name | SUNSHINE CARE PERSONAL CARE AGENCY
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Dates
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Enumeration Date | 01/11/2013
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Last Update Date | 01/11/2013
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Provider Practice Location Address
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Address Line | 1101 W CLAIREMONT AVE STE 1B
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City | EAU CLAIRE
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State | WI
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Zip | 54701-6161
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Country | US
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Telephone | 715-514-5566
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Fax |
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Provider Business Mailing Address
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Address Line | 3208 E WASHINGTON AVE
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City | MADISON
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State | WI
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Zip | 53704-4333
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Country | US
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Telephone | 608-244-1160
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Fax |
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Authorized Official
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Title or Position | DIRECTOR OF BILLING
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Name | MR. SONGLUE VUE
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Credential |
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Telephone | 608-244-1160
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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