Provider Demographics
NPI:1134376973
Name:SUNRISE ASSISTED LIVING
Entity type:Organization
Organization Name:SUNRISE ASSISTED LIVING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASSISTANT ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHRISSIE
Authorized Official - Middle Name:D
Authorized Official - Last Name:THORNTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:907-631-3971
Mailing Address - Street 1:801 S HERMON RD
Mailing Address - Street 2:
Mailing Address - City:WASILLA
Mailing Address - State:AK
Mailing Address - Zip Code:99654-7311
Mailing Address - Country:US
Mailing Address - Phone:907-631-3971
Mailing Address - Fax:907-631-4085
Practice Address - Street 1:801 S HERMON RD
Practice Address - Street 2:
Practice Address - City:WASILLA
Practice Address - State:AK
Practice Address - Zip Code:99654-7311
Practice Address - Country:US
Practice Address - Phone:907-631-3971
Practice Address - Fax:907-631-4085
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-23
Last Update Date:2008-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK100689310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility