Provider Demographics
NPI:1326230392
Name:SUNRIE SANDY SENIOR LIVING LLC
Entity Type:Organization
Organization Name:SUNRIE SANDY SENIOR LIVING LLC
Other - Org Name:SUNRISE OF SANDY ALII
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:RYAN
Authorized Official - Middle Name:
Authorized Official - Last Name:DUVE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-453-9600
Mailing Address - Street 1:2130 E 9400 S
Mailing Address - Street 2:
Mailing Address - City:SANDY
Mailing Address - State:UT
Mailing Address - Zip Code:84093
Mailing Address - Country:US
Mailing Address - Phone:801-453-9600
Mailing Address - Fax:801-453-9601
Practice Address - Street 1:2101 E 9400 S
Practice Address - Street 2:
Practice Address - City:SANDY
Practice Address - State:TN
Practice Address - Zip Code:84093
Practice Address - Country:US
Practice Address - Phone:801-453-9600
Practice Address - Fax:801-453-9601
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-14
Last Update Date:2007-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility