MEDICARE: SUNNYDAYS HOME CARE 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	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1164772265
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SUNNYDAYS HOME CARE INC

Provider Business Mailing Address
First Line	:	2270 SOUTH PKWY
Second Line	:
City	:	VICTORIA
State	:	MN
Zip	:	55386-4538
Country	:	US
Telephone Number	:	612-386-5595
Fax Number	:

Provider Business Practice Location Address
First Line	:	2270 SOUTH PKWY
Second Line	:
City	:	VICTORIA
State	:	MN
Zip	:	55386-4538
Country	:	US
Telephone Number	:	612-386-5595
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	KELLY ANN PETERS
Credential	:	MA OTR/L
Telephone Number	:	612-386-5595

Provider Enumeration Date	:	09/16/2012
Last Update Date	:	09/16/2012

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