# SUNSHINE THERAPY CLUB INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1962687319
- **Authorized official:** TARAYA J SHIRDAN (EXECUTIVE DIRECTOR)
- **Authorized official phone:** (610) 853-9919

## Contact information

- **Practice address:** 410 W TOWNSHIP LINE RD, SUITE 4, HAVERTOWN, PA 19083-5237
- **Practice address phone:** (610) 853-9919
- **Practice address fax:** (610) 853-9921
- **Mailing address:** 410 W TOWNSHIP LINE RD, SUITE 4, HAVERTOWN, PA 19083-5237
- **Mailing address phone:** (610) 853-9919
- **Mailing address fax:** (610) 853-9921

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 104100000X | Social Worker | — | NULL | Yes |
| 104100000X | Social Worker | — | — | Yes |

## Other

- **Enumeration date:** 01/04/2008
- **Last updated:** 03/24/2016

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1000061970006 | — | PA |