| Organization Name: | SUN LIFE FAMILY HEALTH CENTER, INC. |
| NPI Number: | 1902018856 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | DONELLE HOLLEVOET (CREDENTIALING SPECIALIST) |
| Mailing Address: | 1870 W American Ave Oracle |
| State: | AZ US |
| Postal Code: | 856236015 |
| Phone Number: | 5208962092 |
| Fax Number: | 5208962449 |
| NPI Enumeration Date: | 05/04/2007 |
| NPI Last Update Date: | 08/27/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QF0400X |
| License Number: | OTC-3743 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | AZ |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Federally Qualified Health Center (FQHC) |
| Taxonomy Definition: | |