Provider Demographics
NPI:1396330130
Name:SUNFLOWER HAVEN ALF LLC
Entity type:Organization
Organization Name:SUNFLOWER HAVEN ALF LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:ROSA
Authorized Official - Middle Name:MARIA
Authorized Official - Last Name:GARRIGA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-481-1121
Mailing Address - Street 1:10905 N LANTANA AVE
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33612-5957
Mailing Address - Country:US
Mailing Address - Phone:813-481-1121
Mailing Address - Fax:813-374-5200
Practice Address - Street 1:10905 N LANTANA AVE
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33612-5957
Practice Address - Country:US
Practice Address - Phone:813-481-1121
Practice Address - Fax:813-374-5200
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-03
Last Update Date:2021-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility