Provider Demographics
NPI:1215461488
Name:SUNSHINE VILLAGE, INC.
Entity type:Organization
Organization Name:SUNSHINE VILLAGE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:JEFF
Authorized Official - Middle Name:
Authorized Official - Last Name:POLLIER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:413-592-6142
Mailing Address - Street 1:75 LITWIN LN
Mailing Address - Street 2:
Mailing Address - City:CHICOPEE
Mailing Address - State:MA
Mailing Address - Zip Code:01020-4817
Mailing Address - Country:US
Mailing Address - Phone:413-592-6142
Mailing Address - Fax:413-598-0478
Practice Address - Street 1:75 LITWIN LN
Practice Address - Street 2:BUILDING 2 LITWIN CENTER
Practice Address - City:CHICOPEE
Practice Address - State:MA
Practice Address - Zip Code:01020-4817
Practice Address - Country:US
Practice Address - Phone:413-592-6142
Practice Address - Fax:413-598-0478
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-14
Last Update Date:2017-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA110027897AMedicaid
MA110027897HMedicaid
MA110027897GMedicaid
MA110027897FMedicaid
MA110027897IMedicaid