Provider Demographics
NPI:1164662680
Name:SUNRISE EASTOVER ASSISTED LIVING, LLC
Entity Type:Organization
Organization Name:SUNRISE EASTOVER ASSISTED LIVING, LLC
Other - Org Name:SUNRISE SENIOR LIVING OF EASTOVER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:CODY
Authorized Official - Middle Name:M
Authorized Official - Last Name:TOWER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-366-2550
Mailing Address - Street 1:3610 RANDOLPH RD
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28211-1318
Mailing Address - Country:US
Mailing Address - Phone:704-366-2550
Mailing Address - Fax:704-366-4041
Practice Address - Street 1:3610 RANDOLPH RD
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28211-1318
Practice Address - Country:US
Practice Address - Phone:704-366-2550
Practice Address - Fax:704-366-4041
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-24
Last Update Date:2009-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility