Healthcare Provider Details

I. General information

NPI: 1962694935
Provider Name (Legal Business Name): SUNRISE CARMEL ASSISTED LIVING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/14/2007
Last Update Date: 08/14/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 EXECUTIVE DR
CARMEL ID
46032
US

IV. Provider business mailing address

301 EXECUTIVE DR
CARMEL ID
46032
US

V. Phone/Fax

Practice location:
  • Phone: 317-580-0389
  • Fax: 317-843-9790
Mailing address:
  • Phone: 317-580-0389
  • Fax: 317-843-9790

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State

VIII. Authorized Official

Name: CHANDRA L. STRADLING
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 317-580-0389