Provider Demographics
NPI:1962706929
Name:SUNSHINE HOMECARE
Entity type:Organization
Organization Name:SUNSHINE HOMECARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:WENDY
Authorized Official - Middle Name:YVONNE
Authorized Official - Last Name:MAUST
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:419-207-9900
Mailing Address - Street 1:320 PLEASANT ST
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:OH
Mailing Address - Zip Code:44805-2029
Mailing Address - Country:US
Mailing Address - Phone:419-207-9900
Mailing Address - Fax:419-207-1300
Practice Address - Street 1:320 PLEASANT ST
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:OH
Practice Address - Zip Code:44805
Practice Address - Country:US
Practice Address - Phone:419-207-9900
Practice Address - Fax:419-207-1300
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-06
Last Update Date:2019-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH3115051Medicaid