Provider Demographics
NPI:1881849362
Name:A.L. U.S./SAN GABRIEL SENIOR HOUSING, L.P.
Entity Type:Organization
Organization Name:A.L. U.S./SAN GABRIEL SENIOR HOUSING, L.P.
Other - Org Name:SUNRISE ASSISTED LIVING AT SAN MARINO
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MONICA
Authorized Official - Middle Name:
Authorized Official - Last Name:PAVELKA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:626-292-7800
Mailing Address - Street 1:8332 HUNTINGTON DR
Mailing Address - Street 2:
Mailing Address - City:SAN GABRIEL
Mailing Address - State:CA
Mailing Address - Zip Code:91775-1038
Mailing Address - Country:US
Mailing Address - Phone:626-292-7800
Mailing Address - Fax:626-292-7804
Practice Address - Street 1:8332 HUNTINGTON DR
Practice Address - Street 2:
Practice Address - City:SAN GABRIEL
Practice Address - State:CA
Practice Address - Zip Code:91775-1038
Practice Address - Country:US
Practice Address - Phone:626-292-7800
Practice Address - Fax:626-292-7804
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-25
Last Update Date:2008-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility