Provider Demographics
NPI:1871720391
Name:SUNSHINE ON THE GO NURSING, INC.
Entity type:Organization
Organization Name:SUNSHINE ON THE GO NURSING, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:CARLECIA
Authorized Official - Middle Name:RENA
Authorized Official - Last Name:MCBRYDE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-877-8094
Mailing Address - Street 1:9131 PISCATAWAY RD STE 610
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:MD
Mailing Address - Zip Code:20735-2568
Mailing Address - Country:US
Mailing Address - Phone:301-877-8094
Mailing Address - Fax:888-875-9926
Practice Address - Street 1:4400 STAMP RD
Practice Address - Street 2:SUITE 308
Practice Address - City:TEMPLE HILLS
Practice Address - State:MD
Practice Address - Zip Code:20748-6716
Practice Address - Country:US
Practice Address - Phone:240-695-1772
Practice Address - Fax:240-695-1888
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SUNSHINE CARE TEAM , INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-06-11
Last Update Date:2024-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD080801251E00000X, 251J00000X, 253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care
No251E00000XAgenciesHome Health
No253Z00000XAgenciesIn Home Supportive Care