Provider Demographics
NPI:1215447370
Name:SUNBEAM HOME HEALTHCARE, LLC
Entity type:Organization
Organization Name:SUNBEAM HOME HEALTHCARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:RAYMOND
Authorized Official - Middle Name:L
Authorized Official - Last Name:LEACH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:918-358-8040
Mailing Address - Street 1:1004 N BROADWAY ST
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OK
Mailing Address - Zip Code:74020-1237
Mailing Address - Country:US
Mailing Address - Phone:918-358-8040
Mailing Address - Fax:918-358-8040
Practice Address - Street 1:1004 N BROADWAY ST
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OK
Practice Address - Zip Code:74020-1237
Practice Address - Country:US
Practice Address - Phone:918-640-4759
Practice Address - Fax:918-640-4759
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-03
Last Update Date:2017-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK1194271577OtherHOME THERAPY