Healthcare Provider Details

I. General information

NPI: 1639266851
Provider Name (Legal Business Name): SUNRISE MANOR & CONVALESCENT CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/09/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3434 STATE ROUTE 132
AMELIA OH
45102-2012
US

IV. Provider business mailing address

PO BOX 54923
CINCINNATI OH
45254-0923
US

V. Phone/Fax

Practice location:
  • Phone: 513-797-5144
  • Fax: 513-797-4627
Mailing address:
  • Phone: 513-797-5144
  • Fax: 513-797-4627

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code313M00000X
TaxonomyNursing Facility/Intermediate Care Facility
License Number1221N
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number1221N
License Number StateOH

VIII. Authorized Official

Name: PATRICIA A MEEKER
Title or Position: BOARD OF DIRECTOR
Credential: LNHA
Phone: 513-797-5144