MEDICARE: SUNSHINE CARE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	310400000X	Assisted Living Facility

General Provider Information

NPI Number	:	1023158003
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SUNSHINE CARE

Provider Business Mailing Address
First Line	:	2458 HARRY WURZBACH RD
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78209-5002
Country	:	US
Telephone Number	:	210-804-1663
Fax Number	:

Provider Business Practice Location Address
First Line	:	2458 HARRY WURZBACH RD
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78209-5002
Country	:	US
Telephone Number	:	210-804-1663
Fax Number	:

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MILDRED WALKER
Credential	:
Telephone Number	:	210-804-1663

Provider Enumeration Date	:	02/07/2007
Last Update Date	:	10/03/2007

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Directions to “SUNSHINE CARE ” Practice Location

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