Basic Information
Provider Information
NPI: 1679526156
EntityType: 2
ReplacementNPI:  
OrganizationName: SUNRISE SENIOR LIVING SERVICES, INC
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName: BRIGHTON GARDEN OF SALT LAKE CITY
OtherOrganizationType: 3
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 7900 WESTPARK DR
Address2: T-900, ATT: MEDICARE BLLING, M. GARCIA
City: MC LEAN
State: VA
PostalCode: 221024242
CountryCode: US
TelephoneNumber: 7038540823
FaxNumber: 7038540164
Practice Location
Address1: 76 S 500 E
Address2:  
City: SALT LAKE CITY
State: UT
PostalCode: 841021044
CountryCode: US
TelephoneNumber: 8013590050
FaxNumber: 8013590080
Other Information
ProviderEnumerationDate: 05/18/2006
LastUpdateDate: 04/21/2010
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: WRIGHT
AuthorizedOfficialFirstName: GEORGE
AuthorizedOfficialMiddleName: B
AuthorizedOfficialTitleorPosition: EXECUTIVE DIRECTOR
AuthorizedOfficialTelephone: 8013590050
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
314000000X2005NCF9503UTY Nursing & Custodial Care FacilitiesSkilled Nursing Facility 

No ID Information.


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