Basic Information
| Provider Information | |||||||||
| NPI: | 1104879139 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | SUNRISE SENIOR LIVING SERVICES, INC | ||||||||
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| OtherOrganizationName: | BIRGHTON GARDEN YORBA LINDA | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7900 WESTPARK DR | ||||||||
| Address2: | T-900, ATT: MEDICARE BILLING, M. GARCIA | ||||||||
| City: | MC LEAN | ||||||||
| State: | VA | ||||||||
| PostalCode: | 221024242 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7038540823 | ||||||||
| FaxNumber: | 7038540164 | ||||||||
| Practice Location | |||||||||
| Address1: | 17803 IMPERIAL HWY | ||||||||
| Address2: | |||||||||
| City: | YORBA LINDA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 928862371 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7147779666 | ||||||||
| FaxNumber: | 7147779647 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/19/2006 | ||||||||
| LastUpdateDate: | 04/21/2010 | ||||||||
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| AuthorizedOfficialLastName: | GOLDSMITH | ||||||||
| AuthorizedOfficialFirstName: | GLEN | ||||||||
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| AuthorizedOfficialTitleorPosition: | EXECUTIVE DIRECTOR | ||||||||
| AuthorizedOfficialTelephone: | 7147779666 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 314000000X | 60000546 | CA | Y | Nursing & Custodial Care Facilities | Skilled Nursing Facility |
No ID Information.