Provider Demographics
NPI:1447203468
Name:SUNRISE CONTINUING CARE LLC
Entity Type:Organization
Organization Name:SUNRISE CONTINUING CARE LLC
Other - Org Name:BEDFORD COURT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:TODD
Authorized Official - Middle Name:
Authorized Official - Last Name:MARGLIES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-598-2900
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 1:3701 INTERNATIONAL DR
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20906-1556
Practice Address - Country:US
Practice Address - Phone:301-598-2900
Practice Address - Fax:301-598-0715
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-19
Last Update Date:2013-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD15050314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD941101100Medicaid
MD941101100Medicaid