Provider Demographics
NPI:1174000830
Name:SUNSHINE BEHAVIORAL HEALTH GROUP
Entity type:Organization
Organization Name:SUNSHINE BEHAVIORAL HEALTH GROUP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF COMPLIANCE AND REGULATO
Authorized Official - Prefix:
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:
Authorized Official - Last Name:VANHOOSER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:949-750-2014
Mailing Address - Street 1:DEPT #880624 PO BOX 29650
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85038-9650
Mailing Address - Country:US
Mailing Address - Phone:949-835-4369
Mailing Address - Fax:
Practice Address - Street 1:17975 SKY PARK CIR STE B
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92614-6330
Practice Address - Country:US
Practice Address - Phone:719-602-3268
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-25
Last Update Date:2024-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory