Provider Demographics
NPI:1831510262
Name:SUNNYSIDE PRESBYTERIAN HOME
Entity type:Organization
Organization Name:SUNNYSIDE PRESBYTERIAN HOME
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE ASSISTANT
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:
Authorized Official - Last Name:KANNEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:540-568-8206
Mailing Address - Street 1:600 UNIVERSITY BLVD STE L
Mailing Address - Street 2:
Mailing Address - City:HARRISONBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22801-3763
Mailing Address - Country:US
Mailing Address - Phone:540-568-8206
Mailing Address - Fax:
Practice Address - Street 1:600 UNIVERSITY BLVD STE L
Practice Address - Street 2:
Practice Address - City:HARRISONBURG
Practice Address - State:VA
Practice Address - Zip Code:22801-3763
Practice Address - Country:US
Practice Address - Phone:540-568-8206
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-03
Last Update Date:2020-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VANH2700313M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility