Provider Demographics
NPI:1255481222
Name:SUN HEALTH GRANDVIEW TERRACE
Entity Type:Organization
Organization Name:SUN HEALTH GRANDVIEW TERRACE
Other - Org Name:SUN HEALTH GRANDVIEW CARE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EVP/COO
Authorized Official - Prefix:
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:A
Authorized Official - Last Name:GRAMBOW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:623-832-4335
Mailing Address - Street 1:14719 W GRAND AVE
Mailing Address - Street 2:
Mailing Address - City:SURPRISE
Mailing Address - State:AZ
Mailing Address - Zip Code:85374-7203
Mailing Address - Country:US
Mailing Address - Phone:623-832-4335
Mailing Address - Fax:
Practice Address - Street 1:14505 W GRANITE VALLEY DR
Practice Address - Street 2:
Practice Address - City:SUN CITY WEST
Practice Address - State:AZ
Practice Address - Zip Code:85375-5795
Practice Address - Country:US
Practice Address - Phone:623-975-8100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-11
Last Update Date:2022-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZNCI-1468314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ035265Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER