Provider Demographics
NPI:1639574825
Name:SUGARLAND SNF, LLC
Entity Type:Organization
Organization Name:SUGARLAND SNF, LLC
Other - Org Name:THE SYCAMORES AT SUGAR LAND
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ALEXANDER
Authorized Official - Middle Name:
Authorized Official - Last Name:WASHBURN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:206-453-0290
Mailing Address - Street 1:1910 FAIRVIEW AVE E
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98102-3620
Mailing Address - Country:US
Mailing Address - Phone:206-453-0290
Mailing Address - Fax:206-694-2705
Practice Address - Street 1:770 BROOK STREET
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77478
Practice Address - Country:US
Practice Address - Phone:281-565-6722
Practice Address - Fax:206-694-2705
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-30
Last Update Date:2015-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility