SUN LIFE CENTER FOR CHILDREN – NPI #1417286568
Clinic/Center

SUN LIFE CENTER FOR CHILDREN is an AHC clinic located in CASA GRANDE, AZ. NPPES has assigned the NPI number 1417286568 to SUN LIFE CENTER FOR CHILDREN on December 21, 2009. It is a Type-2 NPI, indicating this NPI number is associated with an organization. Since the name “SUN LIFE CENTER FOR CHILDREN” is a dba name, the actual legal business name for this organization is SUN LIFE FAMILY HEALTH CENTER, INC. The primary taxonomy selected by this provider is 261QF0400X from the Health Care Provider Taxonomy code set, which is classified as Clinic/Center, specializing in Federally Qualified Health Center (FQHC)

The NPI profile was previously updated about 9 years ago on Aug 03, 2017. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for SUN LIFE CENTER FOR CHILDREN below.

NPI Profile for
SUN LIFE FAMILY HEALTH CENTER, INC

NPI Number
1417286568
Enumeration Date

(more than 16 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
SUN LIFE FAMILY HEALTH CENTER, INC
Doing Business As (dba): SUN LIFE CENTER FOR CHILDREN
Primary location
1856 E FLORENCE BLVD
CASA GRANDE, AZ 85122-5303
Phone: (520) 381-0380 Fax: (520) 836-1826
Mailing address
PO BOX 10097
CASA GRANDE, AZ 85130-0020
Phone: (520) 836-3446 Fax: (520) 836-8807
Organization Subpart
No
Authorized Official
TRAVIS ROBINETTE
CHIEF EXECUTIVE OFFICER
Phone: (520) 836-3446
Updated
Identifiers

Identifiers for SUN LIFE CENTER FOR CHILDREN

Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.

DescriptionIssuerStateIdentifier
OTHERCITY BUSINESS LICENSEAZBL-09-55271
OTHERMEDICAREAZ03-1881
OTHERMEDICAREAZZFQ31815
MEDICAIDAZAZ13154
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
261QF0400X
- Clinic/Center / Federally Qualified Health Center (FQHC) (Primary)		 AZ OTC4752

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.