Provider Demographics
NPI:1699553255
Name:SUNNY VILLA INC.
Entity type:Organization
Organization Name:SUNNY VILLA INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:YUNG
Authorized Official - Middle Name:MIN
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-437-0477
Mailing Address - Street 1:222 N HARVARD BLVD
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90004-4319
Mailing Address - Country:US
Mailing Address - Phone:818-437-0477
Mailing Address - Fax:
Practice Address - Street 1:1857 SHEDDON ST
Practice Address - Street 2:
Practice Address - City:FULLERTON
Practice Address - State:CA
Practice Address - Zip Code:92833-5659
Practice Address - Country:US
Practice Address - Phone:818-437-0477
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-15
Last Update Date:2023-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility