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General NPI Number Information
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NPI Number | 1578169892
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Entity Type | Organization
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Legal Business Name | SUNSET LIVING LLC
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Dates
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Enumeration Date | 12/10/2020
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Last Update Date | 12/10/2020
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Provider Practice Location Address
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Address Line | 858 E 100 S
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City | SPANISH FORK
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State | UT
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Zip | 84660-2240
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Country | US
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Telephone | 801-798-8188
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1614
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City | SPANISH FORK
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State | UT
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Zip | 84660-7614
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Country | US
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Telephone | 801-360-4118
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Fax |
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Authorized Official
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Title or Position | ADMIN
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Name | DENNIS MCGRAW
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Credential |
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Telephone | 801-360-4118
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number |
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License Number State |
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