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General NPI Number Information
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NPI Number | 1295992246
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Entity Type | Organization
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Legal Business Name | SUN HEALTH GRANDVIEW TERRACE, LLP
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Dates
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Enumeration Date | 05/19/2008
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Last Update Date | 12/10/2015
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Provider Practice Location Address
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Address Line | 14515 W GRANITE VALLEY DR
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City | SUN CITY WEST
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State | AZ
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Zip | 85375-6021
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Country | US
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Telephone | 623-975-8042
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Fax |
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Provider Business Mailing Address
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Address Line | 14515 W GRANITE VALLEY DR
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City | SUN CITY WEST
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State | AZ
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Zip | 85375-6021
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Country | US
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Telephone | 623-975-8042
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | BHAKTI GOSALIA
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Credential |
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Telephone | 623-975-8030
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | OTC 3844
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License Number State | AZ
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