Provider Demographics
NPI:1417112608
Name:SUNRISE SENIOR LIVING MANAGEMENT, INC.
Entity Type:Organization
Organization Name:SUNRISE SENIOR LIVING MANAGEMENT, INC.
Other - Org Name:SUNRISE OF DES PERES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:TOM
Authorized Official - Middle Name:
Authorized Official - Last Name:BROZKA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-965-3800
Mailing Address - Street 1:13460 MANCHESTER RD
Mailing Address - Street 2:
Mailing Address - City:DES PERES
Mailing Address - State:MO
Mailing Address - Zip Code:63131-1734
Mailing Address - Country:US
Mailing Address - Phone:314-965-3800
Mailing Address - Fax:314-965-3809
Practice Address - Street 1:13460 MANCHESTER RD
Practice Address - Street 2:
Practice Address - City:DES PERES
Practice Address - State:MO
Practice Address - Zip Code:63131-1734
Practice Address - Country:US
Practice Address - Phone:314-965-3800
Practice Address - Fax:314-965-3809
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-28
Last Update Date:2008-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility