Provider Demographics
NPI:1447405717
Name:SUNQUEST MANOR
Entity Type:Organization
Organization Name:SUNQUEST MANOR
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:
Authorized Official - Last Name:MOLDOVAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-663-2444
Mailing Address - Street 1:5610 E MOUNTAIN VIEW RD
Mailing Address - Street 2:
Mailing Address - City:PARADISE VALLEY
Mailing Address - State:AZ
Mailing Address - Zip Code:85253-1753
Mailing Address - Country:US
Mailing Address - Phone:602-663-2444
Mailing Address - Fax:
Practice Address - Street 1:10419 N 57TH ST
Practice Address - Street 2:
Practice Address - City:PARADISE VALLEY
Practice Address - State:AZ
Practice Address - Zip Code:85253-1140
Practice Address - Country:US
Practice Address - Phone:602-663-2444
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-29
Last Update Date:2008-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZALH4991313M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility