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General NPI Number Information
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NPI Number | 1427304559
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Entity Type | Organization
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Legal Business Name | SUNNY BOWER ALF
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Dates
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Enumeration Date | 07/26/2012
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Last Update Date | 07/26/2012
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Provider Practice Location Address
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Address Line | 1604 71ST ST NW
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City | BRADENTON
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State | FL
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Zip | 34209-1129
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Country | US
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Telephone | 941-792-2144
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Fax | 941-795-6374
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Provider Business Mailing Address
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Address Line | 1604 71ST ST NW
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City | BRADENTON
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State | FL
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Zip | 34209-1129
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Country | US
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Telephone | 941-792-2144
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Fax | 941-795-6374
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MRS. MARIA A GRUMLEY
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Credential |
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Telephone | 941-792-2144
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA0600X
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Taxonomy Name | Adult Day Care Clinic/Center
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License Number | AL5178
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 385H00000X
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Taxonomy Name | Respite Care
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License Number | AL5178
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number | AL5178
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License Number State | FL
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