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Organization

SUNSHINE ASSISTED LIVING

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. ENID BALLENTINE (MANAGER)
(928) 753-9428
Entity
Organization

Contact information

Practice address
1815 AIRFIELD AVE, KINGMAN, AZ 86401-4004
(928) 753-9428
(928) 565-7472
Mailing address
1815 AIRFIELD AVE, KINGMAN, AZ 86401-4004
(928) 753-9428
(928) 565-7472

Taxonomy

Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
ALH6156
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
204833
AZ
Enumeration date
05/31/2007
Last updated
08/08/2008
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