Provider Demographics
NPI:1003119926
Name:SUNRISE OF GILBERT
Entity Type:Organization
Organization Name:SUNRISE OF GILBERT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS OFFICE COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:DARCI
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:CLARK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-632-9400
Mailing Address - Street 1:580 S GILBERT RD
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85296-2201
Mailing Address - Country:US
Mailing Address - Phone:480-632-9400
Mailing Address - Fax:480-632-9401
Practice Address - Street 1:580 S GILBERT RD
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85296-2201
Practice Address - Country:US
Practice Address - Phone:480-632-9400
Practice Address - Fax:480-632-9401
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-15
Last Update Date:2010-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility