Provider Demographics
NPI:1578750089
Name:NAH/SUNRISE SEVERNA PARK, LLC
Entity Type:Organization
Organization Name:NAH/SUNRISE SEVERNA PARK, LLC
Other - Org Name:SUNRISE SENIOR LIVING AT SEVERNA PARK
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SENIOR EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:ROBINSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-544-7200
Mailing Address - Street 1:43 W MCKINSEY RD
Mailing Address - Street 2:
Mailing Address - City:SEVERNA PARK
Mailing Address - State:MD
Mailing Address - Zip Code:21146-4556
Mailing Address - Country:US
Mailing Address - Phone:410-544-7200
Mailing Address - Fax:410-518-6974
Practice Address - Street 1:43 W MCKINSEY RD
Practice Address - Street 2:
Practice Address - City:SEVERNA PARK
Practice Address - State:MD
Practice Address - Zip Code:21146-4556
Practice Address - Country:US
Practice Address - Phone:410-544-7200
Practice Address - Fax:410-518-6974
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-28
Last Update Date:2007-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility