Provider Demographics
NPI:1235308602
Name:SUNNY MEADOWS LIVING CENTER
Entity type:Organization
Organization Name:SUNNY MEADOWS LIVING CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ADMINISTATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:MANDY
Authorized Official - Middle Name:ELAINE
Authorized Official - Last Name:STUCKEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:660-826-5353
Mailing Address - Street 1:419 N PROSPECT AVE
Mailing Address - Street 2:
Mailing Address - City:SEDALIA
Mailing Address - State:MO
Mailing Address - Zip Code:65301-2729
Mailing Address - Country:US
Mailing Address - Phone:660-826-5353
Mailing Address - Fax:660-826-5780
Practice Address - Street 1:419 N PROSPECT AVE
Practice Address - Street 2:
Practice Address - City:SEDALIA
Practice Address - State:MO
Practice Address - Zip Code:65301-2729
Practice Address - Country:US
Practice Address - Phone:660-826-5353
Practice Address - Fax:660-826-5780
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-29
Last Update Date:2008-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO035165320800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness