Basic Information
| Provider Information | |||||||||
| NPI: | 1568493930 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | SUNNY HILLS INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 448 | ||||||||
| Address2: | |||||||||
| City: | DECATUR | ||||||||
| State: | TX | ||||||||
| PostalCode: | 762340448 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9406272165 | ||||||||
| FaxNumber: | 9406275397 | ||||||||
| Practice Location | |||||||||
| Address1: | 201 E THOMPSON ST | ||||||||
| Address2: | |||||||||
| City: | DECATUR | ||||||||
| State: | TX | ||||||||
| PostalCode: | 762342736 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9406272165 | ||||||||
| FaxNumber: | 9406275397 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/05/2006 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | HENDRIX | ||||||||
| AuthorizedOfficialFirstName: | GARY | ||||||||
| AuthorizedOfficialMiddleName: | M. | ||||||||
| AuthorizedOfficialTitleorPosition: | ADMINISTRATOR/SECRETARY OF CORP. | ||||||||
| AuthorizedOfficialTelephone: | 9406272165 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 313M00000X | 4945 | TX | X | Nursing & Custodial Care Facilities | Nursing Facility/Intermediate Care Facility | 314000000X | 676004 | TX | X | Nursing & Custodial Care Facilities | Skilled Nursing Facility |
No ID Information.