MEDICARE: BEST SUNSHINE HOME CARE 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	253Z00000X	In Home Supportive Care Agency		TX

General Provider Information

NPI Number	:	1568847416
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BEST SUNSHINE HOME CARE LLC

Provider Business Mailing Address
First Line	:	9112 WINDSWEPT DR APT 1712
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76116-6659
Country	:	US
Telephone Number	:	682-582-5969
Fax Number	:

Provider Business Practice Location Address
First Line	:	9112 WINDSWEPT DR APT 1712
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76116-6659
Country	:	US
Telephone Number	:	682-582-5969
Fax Number	:

Authorized Official
Title or Position	:	MANAGING MEMBER
Name	:	MR. CELESTIN SYLIDION KAGORORA
Credential	:
Telephone Number	:	682-582-5969

Provider Enumeration Date	:	07/21/2015
Last Update Date	:	07/21/2015

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