NPIMap

Organization Active NPI

Sunshine Therapy Club, Inc

  • Early Intervention Provider Agency
  • Havertown, PA
National Provider Identifier
1003941964
Registry record updated Mar 24, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Early Intervention Provider AgencyTaxonomy code 252Y00000X
Legal business name
SUNSHINE THERAPY CLUB, INC
Practice address
410 W Township Line Road
Suite 4
Havertown, PA 19083
Phone
(610) 853-9918
Fax
(610) 853-9921
NPI assigned
Feb 22, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Ms. Taraya Shirdan
Title
Director
Phone
(610) 853-9919

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care CoordinatorGroup: 193200000X MULTI-SPECIALTY GROUP 171M00000X
Early Intervention Provider Agency 252Y00000X Primary

Addresses

Primary practice location

410 W Township Line Road
Suite 4
Havertown, PA 19083

Mailing address

410 W Township Line Road
Suite 4
Havertown, PA 19083
Phone (610) 853-9918

Other identifiers 1

IdentifierTypeStateIssuer
1000061970007MedicaidPA

National Provider Directory

National Provider Directory
Tax ID family
Sunshine Therapy Club Inc3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1172102400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1458777600000",
    "number": "1003941964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "410 W TOWNSHIP LINE ROAD",
            "address_2": "SUITE 4",
            "city": "HAVERTOWN",
            "state": "PA",
            "postal_code": "19083",
            "telephone_number": "610-853-9918",
            "fax_number": "610-853-9921"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 W TOWNSHIP LINE ROAD",
            "address_2": "SUITE 4",
            "city": "HAVERTOWN",
            "state": "PA",
            "postal_code": "19083",
            "telephone_number": "610-853-9918",
            "fax_number": "610-853-9921"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUNSHINE THERAPY CLUB, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-22",
        "last_updated": "2016-03-24",
        "status": "A",
        "authorized_official_last_name": "SHIRDAN",
        "authorized_official_first_name": "TARAYA",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "610-853-9919",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1000061970007",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Havertown, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.