Organization
SUNSHINE THERAPY CLUB, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. TARAYA SHIRDAN (DIRECTOR)
(610) 853-9919
Entity
Organization
Contact information
Practice address
410 W TOWNSHIP LINE ROAD, SUITE 4, HAVERTOWN, PA 19083
(610) 853-9918
(610) 853-9921
Mailing address
410 W TOWNSHIP LINE ROAD, SUITE 4, HAVERTOWN, PA 19083
(610) 853-9918
(610) 853-9921
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
—
—
252Y00000X
Early Intervention Provider Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1000061970007
—
PA
Enumeration date
02/22/2007
Last updated
03/24/2016
Update your record
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