MEDICARE: SUN VALLEY HOME HEALTH & PHYSICAL THERAPY 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	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1558014795
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SUN VALLEY HOME HEALTH & PHYSICAL THERAPY LLC

Provider Business Mailing Address
First Line	:	156 W AVENUE A
Second Line	:
City	:	BELLE GLADE
State	:	FL
Zip	:	33430-3018
Country	:	US
Telephone Number	:	561-983-8758
Fax Number	:

Provider Business Practice Location Address
First Line	:	156 W AVENUE A
Second Line	:
City	:	BELLE GLADE
State	:	FL
Zip	:	33430-3018
Country	:	US
Telephone Number	:	561-983-8758
Fax Number	:

Authorized Official
Title or Position	:	MGR
Name	:	MRS. MARIE G MENGUAL JOSEPH
Credential	:	APRN
Telephone Number	:	561-574-3165

Provider Enumeration Date	:	01/28/2022
Last Update Date	:	01/28/2022

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