Provider Demographics
NPI:1750307468
Name:SUNLAND HOME FOUNDATION
Entity Type:Organization
Organization Name:SUNLAND HOME FOUNDATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:JANE
Authorized Official - Last Name:COOK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:760-944-2976
Mailing Address - Street 1:691 SPARTA DR
Mailing Address - Street 2:
Mailing Address - City:ENCINITAS
Mailing Address - State:CA
Mailing Address - Zip Code:92024-1821
Mailing Address - Country:US
Mailing Address - Phone:760-944-2976
Mailing Address - Fax:760-944-1460
Practice Address - Street 1:691 SPARTA DR
Practice Address - Street 2:
Practice Address - City:ENCINITAS
Practice Address - State:CA
Practice Address - Zip Code:92024-1821
Practice Address - Country:US
Practice Address - Phone:760-944-2976
Practice Address - Fax:760-944-1460
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-14
Last Update Date:2021-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282J00000XHospitalsReligious Nonmedical Health Care Institution
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA051990Medicare ID - Type Unspecified