Provider Demographics
NPI:1295446474
Name:SUNNY DAYS
Entity type:Organization
Organization Name:SUNNY DAYS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LETAVA
Authorized Official - Middle Name:
Authorized Official - Last Name:MABILIJENGO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:317-210-4818
Mailing Address - Street 1:3624 FIVE POINTS RD REAR DOOR
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46239-9568
Mailing Address - Country:US
Mailing Address - Phone:317-210-4818
Mailing Address - Fax:317-406-9982
Practice Address - Street 1:3624 FIVE POINTS RD REAR DOOR
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46239-9568
Practice Address - Country:US
Practice Address - Phone:317-210-4818
Practice Address - Fax:317-406-9982
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-08
Last Update Date:2022-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251F00000XAgenciesHome Infusion
No251E00000XAgenciesHome Health
No251S00000XAgenciesCommunity/Behavioral Health