SUNSHINE VILLAGE, INC NPI 1992923759

Day Training, Developmentally Disabled Services in West Springfield, MA

NPI 1992923759 Organization Day Training, Developmentally Disabled S... CLIA Number 22D2102744 CLIA Certificate of Waiver

About SUNSHINE VILLAGE, INC

Sunshine Village, Inc is a provider established in West Springfield, Massachusetts specializing in day training, developmentally disabled services. The NPI number of Sunshine Village, Inc is 1992923759 and was assigned on April 2007. The practitioner's primary taxonomy code is 251C00000X. The provider is registered as an organization and their NPI record was last updated 2 years ago. The authorized official of this NPI record is Mr. Sudhakar Vamathevan (Chief Financial Officer)

The CLIA number of Sunshine Village, Inc is 22D2102744 registered as a "other" facility with a CLIA Certificate of Waiver. This CLIA certificate is issued to Sunshine Village, Inc to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

NPI

1992923759

Provider NameSUNSHINE VILLAGE, INC
Provider Location Address389 MAIN ST WEST SPRINGFIELD, MA 01089
Provider Mailing Address75 LITWIN LN CHICOPEE, MA 01020
NPI Entity TypeOrganization
Is Sole Proprietor?N/A
Is Organization Subpart?No
Enumeration Date04-24-2007
Last Update Date08-22-2020


Primary Taxonomy

Taxonomy Code251C00000X
ClassificationDay Training, Developmentally Disabled Services
TypeAgencies
Taxonomy DescriptionThese agencies are authorized to provide day habilitation services to developmentally disabled individuals who live in their homes. The function of day habilitation is to assist an individual to acquire and maintain those life skills that enable the individual to cope more effectively with the demands of independent living. Also to raise the level of the individual's physical, mental, social, and vocational functioning.

Business Address

SUNSHINE VILLAGE, INC
389 MAIN ST
WEST SPRINGFIELD, MA
ZIP 01089
Phone: (413) 737-2992
Fax: (413) 737-3325

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Mailing Address

SUNSHINE VILLAGE, INC
75 LITWIN LN
CHICOPEE, MA
ZIP 01020
Phone: (413) 592-6142
Fax: (413) 598-0478



Authorized Official

Authorized Official NameMR. SUDHAKAR VAMATHEVAN
Authorized Official TitleCHIEF FINANCIAL OFFICER
Authorized Official Phone(413) 592-6142

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for the NPI number 1992923759 is:

CLIA Number22D2102744
Facility TypeOTHER
Certificate TypeCertificate of Waiver

Additional Identifiers


Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State
1310747MEDICAID (05)MA

NPI Footnotes

What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.

Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.

Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.

Entity Type Code
The code describing the type of health care provider that is being assigned an NPI.
The entity type codes are:
1 = Person: individual human being who furnishes health care;
2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)

What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.

Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.

Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).

Last Update Date
The date that a NPI record was last updated or changed.

Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.