Provider Demographics
NPI:1174401269
Name:SUNSHINE ADVANTAGE OF TENNESSEE LLC
Entity type:Organization
Organization Name:SUNSHINE ADVANTAGE OF TENNESSEE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:MIRIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:LICHTSCHEIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:347-971-0039
Mailing Address - Street 1:2170 LAKEWOOD RD STE 206
Mailing Address - Street 2:
Mailing Address - City:TOMS RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08755-1669
Mailing Address - Country:US
Mailing Address - Phone:855-973-1235
Mailing Address - Fax:
Practice Address - Street 1:2170 LAKEWOOD RD STE 206
Practice Address - Street 2:
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08755-1669
Practice Address - Country:US
Practice Address - Phone:855-973-1235
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-26
Last Update Date:2025-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty