Healthcare Provider Details

I. General information

NPI: 1730176850
Provider Name (Legal Business Name): SUNNY VEE NURSING HOME, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/04/2005
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

54 W LINCOLN AVE
DELAWARE OH
43015-1614
US

IV. Provider business mailing address

54 W LINCOLN AVE
DELAWARE OH
43015-1614
US

V. Phone/Fax

Practice location:
  • Phone: 740-363-1587
  • Fax: 740-524-0378
Mailing address:
  • Phone: 740-363-1587
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number2678
License Number StateOH

VIII. Authorized Official

Name: VIVIAN A WRIGHT
Title or Position: ADMINISTRATOR
Credential: OWNER
Phone: 740-363-1587