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SUNSHINE VILLAGE INC NPI 1992923759


NPI Information

NPI: 1992923759
Provider Name: SUNSHINE VILLAGE, INC
Classification: Day Training, Developmentally Disabled Services - 251C00000X
Entity Type: Organization

CLIA Number: 22D2102744

Address:
389 MAIN ST
WEST SPRINGFIELD, MA
ZIP 01089
Phone: (413) 737-2992
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SUNSHINE VILLAGE, INC is a day training developmentally disabled services in West Springfield, MA. The provider is these agencies are authorized to provide day habilitation services to developmentally disabled individuals who live in their homes. The function of day habilitation is to assist an individual to acquire and maintain those life skills that enable the individual to cope more effectively with the demands of independent living. Also to raise the level of the individual's physical, mental, social, and vocational functioning. SUNSHINE VILLAGE, INC NPI is 1992923759. The provider is registered as an organization entity type.

The provider's business location address is:

389 MAIN ST
WEST SPRINGFIELD, MA
ZIP 01089-908
Phone: (413) 737-2992
Fax: (413) 737-3325

The provider's authorized official is Sudhakar Vamathevan .
The authorized official title is Chief Financial Officer and has the following contact phone number (413) 592-6142.

The CLIA number assigned to this NPI record is 22D2102744 - other - dds day program with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 4/24/2007 and was last updated on 8/22/2020.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1251C00000XDay Training, Developmentally Disabled ServicesYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
11310747MEDICAIDMASSACHUSETTS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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