MEDICARE: SUNSHINE BEHAVIORAL HEALTH 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	324500000X	Substance Abuse Rehabilitation Facility

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	300311EP	OTHER	CA	CALIFORNIA DHCS

General Provider Information

NPI Number	:	1972058410
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SUNSHINE BEHAVIORAL HEALTH LLC

Provider Business Mailing Address
First Line	:	PO BOX 29650
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85038-9650
Country	:	US
Telephone Number	:	949-988-0471
Fax Number	:	949-325-7818

Provider Business Practice Location Address
First Line	:	27136B PASEO ESPADA STE 1121
Second Line	:
City	:	SAN JUAN CAPISTRANO
State	:	CA
Zip	:	92675-2725
Country	:	US
Telephone Number	:	949-988-0471
Fax Number	:	949-325-7818

Authorized Official
Title or Position	:	DIRECTOR OF COMPLIANCE
Name	:	STEPHEN VANHOOSER
Credential	:
Telephone Number	:	949-750-2014

Provider Enumeration Date	:	08/24/2016
Last Update Date	:	09/26/2025

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