Provider Demographics
NPI:1710742697
Name:SC ASSISTED LIVING 4 INC
Entity Type:Organization
Organization Name:SC ASSISTED LIVING 4 INC
Other - Org Name:SUNSET COAST LIVING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/OPERATOR
Authorized Official - Prefix:
Authorized Official - First Name:VANESSA
Authorized Official - Middle Name:
Authorized Official - Last Name:NUNEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:619-882-5003
Mailing Address - Street 1:4364 BONITA RD # 334
Mailing Address - Street 2:
Mailing Address - City:BONITA
Mailing Address - State:CA
Mailing Address - Zip Code:91902-1421
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1251 2ND AVE
Practice Address - Street 2:
Practice Address - City:CHULA VISTA
Practice Address - State:CA
Practice Address - Zip Code:91911-3336
Practice Address - Country:US
Practice Address - Phone:619-882-5003
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SUNSET COAST ASSISTED LIVING INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-02-19
Last Update Date:2024-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility