Provider Demographics
NPI:1417126202
Name:HCRI SUN III TENANT, LP
Entity type:Organization
Organization Name:HCRI SUN III TENANT, LP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SENIOR REIMBURSEMENT MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:TONY
Authorized Official - Middle Name:J
Authorized Official - Last Name:HARRIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-854-0830
Mailing Address - Street 1:18605 OLD EXCELSIOR BLVD
Mailing Address - Street 2:
Mailing Address - City:MINNETONKA
Mailing Address - State:MN
Mailing Address - Zip Code:55345-3120
Mailing Address - Country:US
Mailing Address - Phone:952-474-9155
Mailing Address - Fax:752-474-9171
Practice Address - Street 1:18605 OLD EXCELSIOR BLVD
Practice Address - Street 2:
Practice Address - City:MINNETONKA
Practice Address - State:MN
Practice Address - Zip Code:55345-3120
Practice Address - Country:US
Practice Address - Phone:952-474-9155
Practice Address - Fax:752-474-9171
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HCRI SUN III TENANT, LP
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-02-26
Last Update Date:2024-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility