Healthcare Provider Details

I. General information

NPI: 1881379428
Provider Name (Legal Business Name): SUNNYVALE ASSISTED LIVING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/20/2023
Last Update Date: 06/20/2023
Certification Date: 06/20/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7457 HIGHWAY 41A
CEDAR HILL TN
37032-6607
US

IV. Provider business mailing address

7457 HIGHWAY 41A
CEDAR HILL TN
37032-6607
US

V. Phone/Fax

Practice location:
  • Phone: 931-980-5628
  • Fax:
Mailing address:
  • Phone: 931-980-5628
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WH1000X
TaxonomyHospice Registered Nurse
License Number
License Number State

VIII. Authorized Official

Name: ANGELA Y. LOVELL
Title or Position: REGISTERED NURSE
Credential:
Phone: 931-980-5628