Provider Demographics
NPI:1790712206
Name:SUNNYVIEW HEALTH CARE CENTER INC.
Entity Type:Organization
Organization Name:SUNNYVIEW HEALTH CARE CENTER INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSING HOME ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:LISA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:SORENSEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:920-295-6463
Mailing Address - Street 1:900 SUNNYVIEW LN
Mailing Address - Street 2:
Mailing Address - City:PRINCETON
Mailing Address - State:WI
Mailing Address - Zip Code:54968-9262
Mailing Address - Country:US
Mailing Address - Phone:920-295-6463
Mailing Address - Fax:920-295-4412
Practice Address - Street 1:900 SUNNYVIEW LN
Practice Address - Street 2:
Practice Address - City:PRINCETON
Practice Address - State:WI
Practice Address - Zip Code:54968-9262
Practice Address - Country:US
Practice Address - Phone:920-295-6463
Practice Address - Fax:920-295-4412
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2569314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI20193400Medicaid
WI20193400Medicaid