Provider Demographics
NPI:1851664981
Name:SUNRISE SPRINGFIELD ASSISTED LIVING LLC
Entity Type:Organization
Organization Name:SUNRISE SPRINGFIELD ASSISTED LIVING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ROBINETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:TODD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-922-6800
Mailing Address - Street 1:6541 FRANCONIA RD
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:22150-1409
Mailing Address - Country:US
Mailing Address - Phone:703-922-6800
Mailing Address - Fax:703-922-4898
Practice Address - Street 1:6541 FRANCONIA RD
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:VA
Practice Address - Zip Code:22150-1801
Practice Address - Country:US
Practice Address - Phone:703-922-6800
Practice Address - Fax:703-922-4898
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-21
Last Update Date:2012-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VAALF 1080630-L155310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility