Provider Demographics
NPI:1710256888
Name:SUNSET AFFORDABLE HEALTHCARE LLC
Entity Type:Organization
Organization Name:SUNSET AFFORDABLE HEALTHCARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT/TREASURER
Authorized Official - Prefix:MRS
Authorized Official - First Name:TARA
Authorized Official - Middle Name:AISHA
Authorized Official - Last Name:POLK
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:216-261-7774
Mailing Address - Street 1:26300 EUCLID AVE
Mailing Address - Street 2:SUITE 542
Mailing Address - City:EUCLID
Mailing Address - State:OH
Mailing Address - Zip Code:44132-3708
Mailing Address - Country:US
Mailing Address - Phone:216-261-7774
Mailing Address - Fax:216-261-7775
Practice Address - Street 1:26300 EUCLID AVE
Practice Address - Street 2:SUITE 542
Practice Address - City:EUCLID
Practice Address - State:OH
Practice Address - Zip Code:44132-3708
Practice Address - Country:US
Practice Address - Phone:216-261-7774
Practice Address - Fax:216-261-7775
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-20
Last Update Date:2011-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health