Healthcare Provider Details

I. General information

NPI: 1073597746
Provider Name (Legal Business Name): SUNSET NURSING AND REHABILITATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/06/2005
Last Update Date: 09/26/2024
Certification Date: 09/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

232 ACADEMY ST 232 ACADEMY ST
BOONVILLE NY
13309-1397
US

IV. Provider business mailing address

232 ACADEMY ST 232 ACADEMY STREET
BOONVILLE NY
13309-1397
US

V. Phone/Fax

Practice location:
  • Phone: 315-942-4301
  • Fax: 315-942-5994
Mailing address:
  • Phone: 315-942-4301
  • Fax: 315-942-5994

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number3221301N
License Number StateNY

VIII. Authorized Official

Name: MR. RALPH ROSSO
Title or Position: CFO
Credential:
Phone: 716-829-1554