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General NPI Number Information
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NPI Number | 1386306504
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Entity Type | Organization
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Legal Business Name | SUNNYBROOK OPERATIONS LLC
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Dates
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Enumeration Date | 10/06/2021
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Last Update Date | 12/20/2021
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Provider Practice Location Address
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Address Line | 400 HIGHLAND ST
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City | FAIRFIELD
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State | IA
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Zip | 52556-3713
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Country | US
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Telephone | 641-209-1600
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Fax |
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Provider Business Mailing Address
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Address Line | 400 HIGHLAND ST
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City | FAIRFIELD
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State | IA
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Zip | 52556-3713
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | YISROEL KAPLAN
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Credential |
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Telephone | 917-337-8816
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number |
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License Number State |
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