Provider Demographics
NPI:1053053900
Name:SUNSET VISTA FIRST LLC
Entity Type:Organization
Organization Name:SUNSET VISTA FIRST LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:NASH
Authorized Official - Middle Name:
Authorized Official - Last Name:ZAITOON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:805-844-0126
Mailing Address - Street 1:18606 N 2ND AVE
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85027-6614
Mailing Address - Country:US
Mailing Address - Phone:623-266-2525
Mailing Address - Fax:623-440-9796
Practice Address - Street 1:18606 N 2ND AVE
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85027-6614
Practice Address - Country:US
Practice Address - Phone:623-266-2525
Practice Address - Fax:623-440-9796
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-11
Last Update Date:2022-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZAL11715OtherASSISTED LIVING LICENSE