MEDICARE: SUNNY DAYS COMMUNITY MENTAL HEALTH CENTER INC

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	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number	:	1164467213
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SUNNY DAYS COMMUNITY MENTAL HEALTH CENTER INC

Provider Business Mailing Address
First Line	:	1440 J F KENNEDY CSWY
Second Line	:	SUITE 130
City	:	NORTH BAY VILLAGE
State	:	FL
Zip	:	33141-4130
Country	:	US
Telephone Number	:	305-981-2200
Fax Number	:	305-981-2211

Provider Business Practice Location Address
First Line	:	1440 J F KENNEDY CSWY
Second Line	:	SUITE 130
City	:	NORTH BAY VILLAGE
State	:	FL
Zip	:	33141-4130
Country	:	US
Telephone Number	:	305-981-2200
Fax Number	:	305-981-2211

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. HUGO PRADERA
Credential	:
Telephone Number	:	305-981-2200

Provider Enumeration Date	:	06/20/2006
Last Update Date	:	06/06/2008

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