Provider Demographics
NPI:1164498044
Name:SUNSET RETIREMENT COMMUNITIES, INC
Entity Type:Organization
Organization Name:SUNSET RETIREMENT COMMUNITIES, INC
Other - Org Name:SUNSET VILLAGE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEL
Authorized Official - Prefix:MS
Authorized Official - First Name:VICTORIA
Authorized Official - Middle Name:S
Authorized Official - Last Name:BARTLETT
Authorized Official - Suffix:
Authorized Official - Credentials:LNHA
Authorized Official - Phone:419-724-1225
Mailing Address - Street 1:9640 SYLVANIA METAMORA RD
Mailing Address - Street 2:
Mailing Address - City:SYLVANIA
Mailing Address - State:OH
Mailing Address - Zip Code:43560-9485
Mailing Address - Country:US
Mailing Address - Phone:419-724-1200
Mailing Address - Fax:419-724-1201
Practice Address - Street 1:9640 SYLVANIA METAMORA RD
Practice Address - Street 2:
Practice Address - City:SYLVANIA
Practice Address - State:OH
Practice Address - Zip Code:43560-9485
Practice Address - Country:US
Practice Address - Phone:419-724-1200
Practice Address - Fax:419-724-1201
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SUNSET RETIREMENT COMMUNITIES, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-02-28
Last Update Date:2012-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH6116314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2305482Medicaid
OH2305482Medicaid