Provider Demographics
NPI:1790306462
Name:SUNSET LIVING LLC
Entity Type:Organization
Organization Name:SUNSET LIVING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:
Authorized Official - Last Name:MCGRAW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-360-4118
Mailing Address - Street 1:PO BOX 1614
Mailing Address - Street 2:
Mailing Address - City:SPANISH FORK
Mailing Address - State:UT
Mailing Address - Zip Code:84660-7614
Mailing Address - Country:US
Mailing Address - Phone:801-360-4118
Mailing Address - Fax:
Practice Address - Street 1:409 S 300 W
Practice Address - Street 2:
Practice Address - City:SANTAQUIN
Practice Address - State:UT
Practice Address - Zip Code:84655-8156
Practice Address - Country:US
Practice Address - Phone:801-754-3995
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-04
Last Update Date:2020-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3104A0630XNursing & Custodial Care FacilitiesAssisted Living FacilityAssisted Living, Behavioral Disturbances
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT2020-ALII-UT207340OtherUTAH STATE HEALTH DEPARTMENT
UT9357132-0160OtherUTAH STATE BUSINESS LICENSING