Provider Demographics
NPI:1598583890
Name:THE SUNRISE VILLAGE LLC
Entity type:Organization
Organization Name:THE SUNRISE VILLAGE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:BUJOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:916-412-6190
Mailing Address - Street 1:7948 SUNRISE BLVD
Mailing Address - Street 2:
Mailing Address - City:CITRUS HEIGHTS
Mailing Address - State:CA
Mailing Address - Zip Code:95610-1531
Mailing Address - Country:US
Mailing Address - Phone:916-412-6190
Mailing Address - Fax:
Practice Address - Street 1:7948 SUNRISE BLVD
Practice Address - Street 2:
Practice Address - City:CITRUS HEIGHTS
Practice Address - State:CA
Practice Address - Zip Code:95610-1531
Practice Address - Country:US
Practice Address - Phone:916-412-6190
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-26
Last Update Date:2024-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility