Provider Demographics
NPI:1073791711
Name:SUNRISE SENIOR LIVING MANAGEMENT, INC.
Entity Type:Organization
Organization Name:SUNRISE SENIOR LIVING MANAGEMENT, INC.
Other - Org Name:SUNRISE ASSISTED LIVING OF ROSEVILLE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ANNELIESE
Authorized Official - Middle Name:
Authorized Official - Last Name:PETERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:651-636-4800
Mailing Address - Street 1:2555 SNELLING AVE N
Mailing Address - Street 2:
Mailing Address - City:ROSEVILLE
Mailing Address - State:MN
Mailing Address - Zip Code:55113-2801
Mailing Address - Country:US
Mailing Address - Phone:651-636-4800
Mailing Address - Fax:651-636-4809
Practice Address - Street 1:2555 SNELLING AVE N
Practice Address - Street 2:
Practice Address - City:ROSEVILLE
Practice Address - State:MN
Practice Address - Zip Code:55113-2801
Practice Address - Country:US
Practice Address - Phone:651-636-4800
Practice Address - Fax:651-636-4809
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-05
Last Update Date:2008-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility