NPIMap

Organization Active NPI

Sunshine Therapy Club II

  • Early Intervention Provider Agency
  • Havertown, PA
National Provider Identifier
1801079454
Registry record updated Apr 13, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Early Intervention Provider AgencyTaxonomy code 252Y00000X
Legal business name
SUNSHINE THERAPY CLUB II
Practice address
410 W Township Line Rd
Suite 4
Havertown, PA 19083-5237
Phone
(610) 853-9919
Fax
(610) 853-9921
NPI assigned
Dec 6, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2016

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

Authorized official

Name
Ms. Taraya J. Shirdan, LPT, M.ED.
Title
Director
Phone
(610) 853-9919

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Early Intervention Provider Agency 252Y00000X
Early Intervention Provider Agency 252Y00000X PA Primary

Addresses

Primary practice location

410 W Township Line Rd
Suite 4
Havertown, PA 19083-5237

Mailing address

410 W Township Line Rd
Suite 4
Havertown, PA 19083-5237
Phone (610) 853-9919

Other identifiers 1

IdentifierTypeStateIssuer
1008092540006MedicaidPA

National Provider Directory

National Provider Directory
Tax ID family
Sunshine Therapy Club II 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": "1196899200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1460505600000",
    "number": "1801079454",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "410 W TOWNSHIP LINE RD",
            "address_2": "SUITE 4",
            "city": "HAVERTOWN",
            "state": "PA",
            "postal_code": "190835237",
            "telephone_number": "610-853-9919",
            "fax_number": "610-853-9921"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 W TOWNSHIP LINE RD",
            "address_2": "SUITE 4",
            "city": "HAVERTOWN",
            "state": "PA",
            "postal_code": "190835237",
            "telephone_number": "610-853-9919",
            "fax_number": "610-853-9921"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUNSHINE THERAPY CLUB II",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-06",
        "last_updated": "2016-04-13",
        "status": "A",
        "authorized_official_last_name": "SHIRDAN",
        "authorized_official_first_name": "TARAYA",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "610-853-9919",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LPT, M.ED."
    },
    "taxonomies": [
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": "PA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1008092540006",
            "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 Apr 13, 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.