Healthcare Provider Details
I. General information
NPI: 1760949267
Provider Name (Legal Business Name): SUNRISE TRANSITIONAL CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/21/2019
Last Update Date: 08/07/2019
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2863 CARMEN AVE
LIVERMORE CA
94550-4808
US
IV. Provider business mailing address
52 OBSIDIAN WAY
LIVERMORE CA
94550-9470
US
V. Phone/Fax
- Phone: 925-989-3345
- Fax: 925-380-1668
- Phone: 925-989-3345
- Fax: 925-380-1668
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 314000000X |
| Taxonomy | Skilled Nursing Facility |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
ANDREW
P
GARCIA
Title or Position: CEO
Credential:
Phone: 925-989-3345