Provider Demographics
NPI:1710798400
Name:SUNSHINE SENIOR CARE SERVICES LLC
Entity type:Organization
Organization Name:SUNSHINE SENIOR CARE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:MUBUKWANU
Authorized Official - Middle Name:KABANJE
Authorized Official - Last Name:MATONDO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:206-910-9024
Mailing Address - Street 1:11721 77TH AVE S
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98178-3807
Mailing Address - Country:US
Mailing Address - Phone:206-910-9024
Mailing Address - Fax:
Practice Address - Street 1:11900 NE 1ST ST
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98005-3046
Practice Address - Country:US
Practice Address - Phone:682-375-9254
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-14
Last Update Date:2025-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care