Provider Demographics
NPI:1033669643
Name:SUNCREST HEALTH CARE INC
Entity Type:Organization
Organization Name:SUNCREST HEALTH CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:
Authorized Official - Last Name:ANDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-305-7134
Mailing Address - Street 1:2211 E SOUTHERN AVE
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85040-3408
Mailing Address - Country:US
Mailing Address - Phone:602-305-7134
Mailing Address - Fax:866-597-7776
Practice Address - Street 1:2211 E SOUTHERN AVE
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85040-3408
Practice Address - Country:US
Practice Address - Phone:602-305-7134
Practice Address - Fax:866-597-7776
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-06
Last Update Date:2016-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility