Provider Demographics
NPI: | 1003380882 |
---|---|
Name: | SUNSHINE INC. RESIDENTIAL AND SUPPORT SERVICES |
Entity type: | Organization |
Organization Name: | SUNSHINE INC. RESIDENTIAL AND SUPPORT SERVICES |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | CHIEF FINANCIAL OFFICER |
Authorized Official - Prefix: | |
Authorized Official - First Name: | MICHAEL |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | BOGDAN |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 419-865-0251 |
Mailing Address - Street 1: | 7223 MAUMEE WESTERN RD |
Mailing Address - Street 2: | |
Mailing Address - City: | MAUMEE |
Mailing Address - State: | OH |
Mailing Address - Zip Code: | 43537-9755 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 419-865-0251 |
Mailing Address - Fax: | 419-865-5607 |
Practice Address - Street 1: | 403 ALLEN ST |
Practice Address - Street 2: | |
Practice Address - City: | WALBRIDGE |
Practice Address - State: | OH |
Practice Address - Zip Code: | 43465-1232 |
Practice Address - Country: | US |
Practice Address - Phone: | 419-865-0251 |
Practice Address - Fax: | 419-865-5607 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2019-01-15 |
Last Update Date: | 2025-06-10 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 315P00000X | Nursing & Custodial Care Facilities | Intermediate Care Facility, Intellectual Disabilities |