Provider Demographics
NPI:1902940562
Name:CHARLEX CORP. USA
Entity Type:Organization
Organization Name:CHARLEX CORP. USA
Other - Org Name:SUNSHINE ICFDDH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:ZAMFIRA
Authorized Official - Middle Name:
Authorized Official - Last Name:VUNDERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:925-736-7913
Mailing Address - Street 1:4110 SUGAR MAPLE DR
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:94506-4639
Mailing Address - Country:US
Mailing Address - Phone:925-736-7913
Mailing Address - Fax:925-736-7914
Practice Address - Street 1:4110 SUGAR MAPLE DR
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:CA
Practice Address - Zip Code:94506-4639
Practice Address - Country:US
Practice Address - Phone:925-736-7913
Practice Address - Fax:925-736-7914
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA05G129320600000X
CA05G781320600000X
CA05G691320600000X
CA05G798320600000X
CA05G435320600000X
CA05G424320600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities