MEDICARE: BARBARA'S SUNNY DAY II, LLC

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	:	1023668415
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BARBARA'S SUNNY DAY II, LLC

Provider Business Mailing Address
First Line	:	3927 BUTTERCUP CIR S
Second Line	:
City	:	PALM BEACH GARDENS
State	:	FL
Zip	:	33410-5670
Country	:	US
Telephone Number	:	561-612-7953
Fax Number	:	561-355-5653

Provider Business Practice Location Address
First Line	:	3927 BUTTERCUP CIR S
Second Line	:
City	:	PALM BEACH GARDENS
State	:	FL
Zip	:	33410-5670
Country	:	US
Telephone Number	:	561-612-7953
Fax Number	:	561-355-5653

Authorized Official
Title or Position	:	OWNER/ADMINISTRATOR
Name	:	SUSAN BARRETT
Credential	:	RN
Telephone Number	:	561-353-8220

Provider Enumeration Date	:	09/17/2019
Last Update Date	:	09/17/2019

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