Provider Demographics
NPI:1174640379
Name:SUNSHINE SERVICES INC
Entity type:Organization
Organization Name:SUNSHINE SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANN
Authorized Official - Middle Name:
Authorized Official - Last Name:VANDEHAAR
Authorized Official - Suffix:
Authorized Official - Credentials:BACHELORS
Authorized Official - Phone:712-262-7805
Mailing Address - Street 1:PO BOX 225
Mailing Address - Street 2:
Mailing Address - City:SPENCER
Mailing Address - State:IA
Mailing Address - Zip Code:51301-0225
Mailing Address - Country:US
Mailing Address - Phone:712-262-7805
Mailing Address - Fax:712-262-8369
Practice Address - Street 1:1106 E 9TH ST
Practice Address - Street 2:
Practice Address - City:SPENCER
Practice Address - State:IA
Practice Address - Zip Code:51301-0225
Practice Address - Country:US
Practice Address - Phone:712-262-7805
Practice Address - Fax:712-262-8369
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251C00000X, 251S00000X
IA210021320900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered251C00000XAgenciesDay Training, Developmentally Disabled Services
Not Answered251S00000XAgenciesCommunity/Behavioral Health
Not Answered320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0177345Medicaid
IA0230300Medicaid