Provider Demographics
NPI:1487109831
Name:RAY OF SUNSHINE EMPOWERMENT SERVICES LLC
Entity type:Organization
Organization Name:RAY OF SUNSHINE EMPOWERMENT SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROPRIETOR
Authorized Official - Prefix:MISS
Authorized Official - First Name:MERRY
Authorized Official - Middle Name:CHRISTMAS
Authorized Official - Last Name:SCHOCH
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:813-523-6573
Mailing Address - Street 1:710 OAKFIELD DR
Mailing Address - Street 2:SUITE 210
Mailing Address - City:BRANDON
Mailing Address - State:FL
Mailing Address - Zip Code:33511-4938
Mailing Address - Country:US
Mailing Address - Phone:813-523-6573
Mailing Address - Fax:813-246-9064
Practice Address - Street 1:710 OAKFIELD DR
Practice Address - Street 2:SUITE 210
Practice Address - City:BRANDON
Practice Address - State:FL
Practice Address - Zip Code:33511-4938
Practice Address - Country:US
Practice Address - Phone:813-523-6573
Practice Address - Fax:813-246-9064
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-15
Last Update Date:2016-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW125681041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IH865AMedicare PIN