Provider Demographics
NPI:1477836229
Name:SUNRISE ADULT CARE ALF, INC.
Entity Type:Organization
Organization Name:SUNRISE ADULT CARE ALF, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DALIA
Authorized Official - Middle Name:
Authorized Official - Last Name:LEMUS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-556-7182
Mailing Address - Street 1:2847 SW 126TH AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33175-2130
Mailing Address - Country:US
Mailing Address - Phone:305-227-5609
Mailing Address - Fax:305-227-5609
Practice Address - Street 1:2847 SW 126TH AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33175-2130
Practice Address - Country:US
Practice Address - Phone:305-227-5609
Practice Address - Fax:305-227-5609
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-27
Last Update Date:2011-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAL12065310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility