Provider Demographics
NPI:1942506118
Name:SUNRISE SENIOR LIVING
Entity Type:Organization
Organization Name:SUNRISE SENIOR LIVING
Other - Org Name:SUNRISE AT FAIR OAKS
Other - Org Type:Other Name
Authorized Official - Title/Position:DIRECTOR OF COMMNITY RELATIONS
Authorized Official - Prefix:MS
Authorized Official - First Name:VALERIE
Authorized Official - Middle Name:
Authorized Official - Last Name:PARKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-264-2043
Mailing Address - Street 1:3750 JOSEPH SIEWICK DR
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22033-1742
Mailing Address - Country:US
Mailing Address - Phone:703-264-0506
Mailing Address - Fax:703-264-0620
Practice Address - Street 1:3750 JOSEPH SIEWICK DR
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22033-1742
Practice Address - Country:US
Practice Address - Phone:703-264-0506
Practice Address - Fax:703-264-0620
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-04
Last Update Date:2011-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VAFLO1079364L152310400000X, 311500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
No311500000XNursing & Custodial Care FacilitiesAlzheimer Center (Dementia Center)