Provider Demographics
NPI:1053698928
Name:SUNNY HILLS OF HOMESTEAD
Entity type:Organization
Organization Name:SUNNY HILLS OF HOMESTEAD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:PHILIPPE
Authorized Official - Middle Name:M
Authorized Official - Last Name:RAYMOND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:863-464-0049
Mailing Address - Street 1:25268 SW 134TH AVE
Mailing Address - Street 2:
Mailing Address - City:HOMESTEAD
Mailing Address - State:FL
Mailing Address - Zip Code:33032-5619
Mailing Address - Country:US
Mailing Address - Phone:305-285-2222
Mailing Address - Fax:305-258-0067
Practice Address - Street 1:25268 SW 134TH AVE
Practice Address - Street 2:
Practice Address - City:HOMESTEAD
Practice Address - State:FL
Practice Address - Zip Code:33032-5619
Practice Address - Country:US
Practice Address - Phone:305-285-2222
Practice Address - Fax:305-258-0067
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-07
Last Update Date:2011-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL10203310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility