Provider Demographics
NPI:1134562648
Name:SUNSET HOME ASSISTED LIVING, INC.
Entity type:Organization
Organization Name:SUNSET HOME ASSISTED LIVING, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:NATHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:ISAAC
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:208-267-0260
Mailing Address - Street 1:510920 HIGHWAY 95
Mailing Address - Street 2:
Mailing Address - City:BONNERS FERRY
Mailing Address - State:ID
Mailing Address - Zip Code:83805-5588
Mailing Address - Country:US
Mailing Address - Phone:208-267-0260
Mailing Address - Fax:208-267-0263
Practice Address - Street 1:510920 HIGHWAY 95
Practice Address - Street 2:
Practice Address - City:BONNERS FERRY
Practice Address - State:ID
Practice Address - Zip Code:83805-5588
Practice Address - Country:US
Practice Address - Phone:208-267-0260
Practice Address - Fax:208-267-0263
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-15
Last Update Date:2023-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDRC 1044310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility