Provider Demographics
NPI:1548559263
Name:SUNSET NURSING HOME INC.
Entity Type:Organization
Organization Name:SUNSET NURSING HOME INC.
Other - Org Name:CREEKSIDE VILLAGE HEALTHCARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:GUINDAL
Authorized Official - Middle Name:A
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:979-230-0407
Mailing Address - Street 1:550 KINGS DR
Mailing Address - Street 2:
Mailing Address - City:FREEPORT
Mailing Address - State:TX
Mailing Address - Zip Code:77541-7700
Mailing Address - Country:US
Mailing Address - Phone:979-230-0407
Mailing Address - Fax:979-233-2604
Practice Address - Street 1:914 BRAZOSPORT BLVD N
Practice Address - Street 2:
Practice Address - City:CLUTE
Practice Address - State:TX
Practice Address - Zip Code:77531-3720
Practice Address - Country:US
Practice Address - Phone:979-230-0407
Practice Address - Fax:979-233-2604
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-04
Last Update Date:2015-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX676304Medicare PIN