Provider Demographics
NPI:1669918405
Name:SUNNYSIDE HOME HEALTH
Entity type:Organization
Organization Name:SUNNYSIDE HOME HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:KIM
Authorized Official - Middle Name:
Authorized Official - Last Name:LAWSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:509-837-1617
Mailing Address - Street 1:PO BOX 719
Mailing Address - Street 2:
Mailing Address - City:SUNNYSIDE
Mailing Address - State:WA
Mailing Address - Zip Code:98944-0719
Mailing Address - Country:US
Mailing Address - Phone:509-837-1614
Mailing Address - Fax:509-837-4908
Practice Address - Street 1:812 MILLER AVE
Practice Address - Street 2:SUITE A
Practice Address - City:SUNNYSIDE
Practice Address - State:WA
Practice Address - Zip Code:98944-2374
Practice Address - Country:US
Practice Address - Phone:509-837-1567
Practice Address - Fax:509-836-0175
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SUNNYSIDE COMMUNITY HOSPITAL ASSOCIATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-01-18
Last Update Date:2017-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health