Provider Demographics
NPI:1720815848
Name:SUNSHINE HOMECARE SERVICES LLC
Entity type:Organization
Organization Name:SUNSHINE HOMECARE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO / MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CATHERINE
Authorized Official - Middle Name:
Authorized Official - Last Name:FOMUNYOH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-797-3073
Mailing Address - Street 1:4441 ARBORWOOD TRL
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76123-2731
Mailing Address - Country:US
Mailing Address - Phone:817-797-3073
Mailing Address - Fax:
Practice Address - Street 1:4441 ARBORWOOD TRL
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76123-2731
Practice Address - Country:US
Practice Address - Phone:817-797-3073
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-14
Last Update Date:2024-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health