Provider Demographics
NPI:1902020399
Name:SUNRISE ASSISTED LIVING OF WILMINGTON
Entity Type:Organization
Organization Name:SUNRISE ASSISTED LIVING OF WILMINGTON
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:LOUIS
Authorized Official - Last Name:FRIEDEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:302-475-9163
Mailing Address - Street 1:2215 SHIPLEY RD
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19803-2305
Mailing Address - Country:US
Mailing Address - Phone:302-475-9163
Mailing Address - Fax:302-475-9164
Practice Address - Street 1:2215 SHIPLEY RD
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19803-2305
Practice Address - Country:US
Practice Address - Phone:302-475-9163
Practice Address - Fax:302-475-9164
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DE1683310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility