Provider Demographics
NPI:1427818897
Name:HOLDEN, SUNSARA DENISE
Entity type:Individual
Prefix:
First Name:SUNSARA
Middle Name:DENISE
Last Name:HOLDEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:377 CHARLES MILLER RD
Mailing Address - Street 2:
Mailing Address - City:HORNBECK
Mailing Address - State:LA
Mailing Address - Zip Code:71439-1610
Mailing Address - Country:US
Mailing Address - Phone:713-816-9243
Mailing Address - Fax:
Practice Address - Street 1:377 CHARLES MILLER RD
Practice Address - Street 2:
Practice Address - City:HORNBECK
Practice Address - State:LA
Practice Address - Zip Code:71439-1610
Practice Address - Country:US
Practice Address - Phone:713-816-9243
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-21
Last Update Date:2024-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility