Provider Demographics
NPI:1285687640
Name:SUNRISE SENIOR LIVING SERVICES INC
Entity Type:Organization
Organization Name:SUNRISE SENIOR LIVING SERVICES INC
Other - Org Name:BRIGHTON GARDEN OF EDISON
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ADAM
Authorized Official - Middle Name:
Authorized Official - Last Name:PARTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:908-767-1031
Mailing Address - Street 1:7900 WESTPARK DR
Mailing Address - Street 2:T-900, ATT: MEDICARE BILLING, M. GARCIA
Mailing Address - City:MC LEAN
Mailing Address - State:VA
Mailing Address - Zip Code:22102-4242
Mailing Address - Country:US
Mailing Address - Phone:703-854-0823
Mailing Address - Fax:703-854-0164
Practice Address - Street 1:1801 OAK TREE RD
Practice Address - Street 2:
Practice Address - City:EDISON
Practice Address - State:NJ
Practice Address - Zip Code:08820-2772
Practice Address - Country:US
Practice Address - Phone:908-767-1031
Practice Address - Fax:908-767-0835
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-18
Last Update Date:2011-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ016222314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ6911609Medicaid
NJ315351Medicare Oscar/Certification