Provider Demographics
NPI:1568202166
Name:SUNGARDEN TERRACE, L.P.
Entity type:Organization
Organization Name:SUNGARDEN TERRACE, L.P.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT OF GENERAL PARTNER
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:WICK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:858-623-9000
Mailing Address - Street 1:2045 SKYLINE DR.
Mailing Address - Street 2:
Mailing Address - City:LEMON GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:91945-4221
Mailing Address - Country:US
Mailing Address - Phone:619-462-5831
Mailing Address - Fax:844-591-9133
Practice Address - Street 1:2045 SKYLINE DR.
Practice Address - Street 2:
Practice Address - City:LEMON GROVE
Practice Address - State:CA
Practice Address - Zip Code:91945-4221
Practice Address - Country:US
Practice Address - Phone:619-462-5831
Practice Address - Fax:844-591-9133
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-30
Last Update Date:2024-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility