Provider Demographics
NPI:1750070538
Name:SUNRISE VISTA ASSISTED LIVING LLC
Entity type:Organization
Organization Name:SUNRISE VISTA ASSISTED LIVING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:
Authorized Official - Last Name:HAUF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:707-508-8984
Mailing Address - Street 1:3342 ARTESIA BLVD
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90504-2501
Mailing Address - Country:US
Mailing Address - Phone:707-508-8984
Mailing Address - Fax:
Practice Address - Street 1:3342 ARTESIA BLVD
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90504-2501
Practice Address - Country:US
Practice Address - Phone:707-508-8984
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HAWTHORNE TERRACE CARE HOME LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-05-05
Last Update Date:2023-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility