Provider Demographics
NPI:1093595316
Name:BUN CIRCLE SENIOR CARE LLC
Entity Type:Organization
Organization Name:BUN CIRCLE SENIOR CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:NILUSHA
Authorized Official - Middle Name:N
Authorized Official - Last Name:ABEYSINGHE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:323-407-0401
Mailing Address - Street 1:21504 GRACE AVE
Mailing Address - Street 2:
Mailing Address - City:CARSON
Mailing Address - State:CA
Mailing Address - Zip Code:90745-2127
Mailing Address - Country:US
Mailing Address - Phone:323-407-0401
Mailing Address - Fax:
Practice Address - Street 1:21504 GRACE AVE
Practice Address - Street 2:
Practice Address - City:CARSON
Practice Address - State:CA
Practice Address - Zip Code:90745-2127
Practice Address - Country:US
Practice Address - Phone:323-407-0401
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-03
Last Update Date:2023-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes376G00000XNursing Service Related ProvidersNursing Home AdministratorGroup - Single Specialty