Provider Demographics
NPI:1407041569
Name:SUNSHINE HOME CARE
Entity type:Organization
Organization Name:SUNSHINE HOME CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:SHARRON
Authorized Official - Middle Name:KAY
Authorized Official - Last Name:DAVIS-BUCKNER
Authorized Official - Suffix:
Authorized Official - Credentials:NURSING HOME ADM
Authorized Official - Phone:314-446-2724
Mailing Address - Street 1:763 S NEW BALLAS RD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63141-8704
Mailing Address - Country:US
Mailing Address - Phone:314-446-2724
Mailing Address - Fax:
Practice Address - Street 1:499 W WALNUT ST
Practice Address - Street 2:
Practice Address - City:WINFIELD
Practice Address - State:MO
Practice Address - Zip Code:63389-1138
Practice Address - Country:US
Practice Address - Phone:636-668-8500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-12
Last Update Date:2007-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO0345863104A0625X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3104A0625XNursing & Custodial Care FacilitiesAssisted Living FacilityAssisted Living, Mental Illness