Healthcare Provider Details

I. General information

NPI: 1609792332
Provider Name (Legal Business Name): SP SUNRISE SEVERNA PARK OPCO LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/26/2026
Last Update Date: 06/26/2026
Certification Date: 06/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

134 RITCHIE HWY
PASADENA MD
21122-4304
US

IV. Provider business mailing address

134 RITCHIE HWY
PASADENA MD
21122-4304
US

V. Phone/Fax

Practice location:
  • Phone: 667-644-2500
  • Fax:
Mailing address:
  • Phone: 667-644-2500
  • Fax:

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: MELISSA PRIEST
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 667-644-2500