Provider Demographics
NPI:1891440517
Name:SUNSET YR LLC
Entity type:Organization
Organization Name:SUNSET YR LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:REINIER
Authorized Official - Middle Name:
Authorized Official - Last Name:RENGIFO
Authorized Official - Suffix:
Authorized Official - Credentials:AMBR
Authorized Official - Phone:786-315-3025
Mailing Address - Street 1:931 NE 17TH TER
Mailing Address - Street 2:
Mailing Address - City:HOMESTEAD
Mailing Address - State:FL
Mailing Address - Zip Code:33033-4633
Mailing Address - Country:US
Mailing Address - Phone:786-315-3025
Mailing Address - Fax:
Practice Address - Street 1:931 NE 17TH TER
Practice Address - Street 2:
Practice Address - City:HOMESTEAD
Practice Address - State:FL
Practice Address - Zip Code:33033-4633
Practice Address - Country:US
Practice Address - Phone:786-315-3025
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-22
Last Update Date:2022-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility