Provider Demographics
NPI:1811723935
Name:SUNSHINE CARE HOME LLC
Entity type:Organization
Organization Name:SUNSHINE CARE HOME LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:JOYCE ANN MARIE
Authorized Official - Middle Name:
Authorized Official - Last Name:MEDINA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-237-3395
Mailing Address - Street 1:3970 MARYLAND AVE
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89121-4559
Mailing Address - Country:US
Mailing Address - Phone:725-309-7083
Mailing Address - Fax:725-204-7272
Practice Address - Street 1:3970 MARYLAND AVE
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89121-4559
Practice Address - Country:US
Practice Address - Phone:725-309-7083
Practice Address - Fax:725-204-7272
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-13
Last Update Date:2024-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home