Provider Demographics
NPI:1881379428
Name:SUNNYVALE ASSISTED LIVING
Entity type:Organization
Organization Name:SUNNYVALE ASSISTED LIVING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTERED NURSE
Authorized Official - Prefix:
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:Y
Authorized Official - Last Name:LOVELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:931-980-5628
Mailing Address - Street 1:7457 HIGHWAY 41A
Mailing Address - Street 2:
Mailing Address - City:CEDAR HILL
Mailing Address - State:TN
Mailing Address - Zip Code:37032-6607
Mailing Address - Country:US
Mailing Address - Phone:931-980-5628
Mailing Address - Fax:
Practice Address - Street 1:7457 HIGHWAY 41A
Practice Address - Street 2:
Practice Address - City:CEDAR HILL
Practice Address - State:TN
Practice Address - Zip Code:37032-6607
Practice Address - Country:US
Practice Address - Phone:931-980-5628
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-20
Last Update Date:2023-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WH1000XNursing Service ProvidersRegistered NurseHospiceGroup - Multi-Specialty