Provider Demographics
NPI:1962069054
Name:SUNNY HAVEN RESIDENTAL SERVICES
Entity type:Organization
Organization Name:SUNNY HAVEN RESIDENTAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MISS
Authorized Official - First Name:MARCIE
Authorized Official - Middle Name:J
Authorized Official - Last Name:ADKINS
Authorized Official - Suffix:
Authorized Official - Credentials:QUID
Authorized Official - Phone:540-480-1555
Mailing Address - Street 1:686 SPOTTSWOOD RD
Mailing Address - Street 2:
Mailing Address - City:STEELES TAVERN
Mailing Address - State:VA
Mailing Address - Zip Code:24476-2000
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:114 COLLINSWOOD DR
Practice Address - Street 2:
Practice Address - City:STAUNTON
Practice Address - State:VA
Practice Address - Zip Code:24401-1988
Practice Address - Country:US
Practice Address - Phone:540-263-0701
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-23
Last Update Date:2019-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities
No315P00000XNursing & Custodial Care FacilitiesIntermediate Care Facility, Intellectual Disabilities