Organization
SUNSHINE THERAPY CLUB II INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. TARAYA J SHIRDAN LPT (EXECUTIVE DIRECTOR)
(610) 853-9919
Entity
Organization
Contact information
Practice address
3300 TOWNSHIP LINE RD, SUITE 102, DREXEL HILL, PA 19026-1925
(610) 853-9919
(610) 853-9921
Mailing address
3300 TOWNSHIP LINE RD, SUITE 102, DREXEL HILL, PA 19026-1925
(610) 853-9919
(610) 853-9921
Taxonomy
Speciality
Code
Description
License number
State
225C00000X
Rehabilitation Counselor
—
—
251C00000X
Developmentally Disabled Services Day Training Agency
—
—
251S00000X
Community/Behavioral Health Agency
—
—
252Y00000X
Early Intervention Provider Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1008092540003
—
PA
Enumeration date
11/02/2010
Last updated
11/04/2010
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