Provider Demographics
NPI:1568212249
Name:SUNDALE CONGREGATE LIVING, INC.
Entity Type:Organization
Organization Name:SUNDALE CONGREGATE LIVING, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CORPORATE SECRETARY
Authorized Official - Prefix:MRS
Authorized Official - First Name:ARNIE
Authorized Official - Middle Name:BELLA
Authorized Official - Last Name:DELA ROSA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:661-496-2802
Mailing Address - Street 1:1805 GLENMONT DR
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93309-3632
Mailing Address - Country:US
Mailing Address - Phone:661-381-7375
Mailing Address - Fax:661-381-7591
Practice Address - Street 1:1805 GLENMONT DR
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93309-3632
Practice Address - Country:US
Practice Address - Phone:661-381-7375
Practice Address - Fax:661-381-7591
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-25
Last Update Date:2024-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility
No314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility