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General NPI Number Information
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NPI Number | 1629280300
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Entity Type | Organization
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Legal Business Name | SUNRISE WAYNE ASSISTED LIVING LLC
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Dates
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Enumeration Date | 05/04/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 184 BERDAN RD
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City | WAYNE
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State | NJ
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Zip | 07470
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Country | US
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Telephone | 973-628-4900
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Fax |
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Provider Business Mailing Address
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Address Line | 184 BERDAN RD
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City | WAYNE
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State | NJ
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Zip | 07470
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Country | US
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Telephone | 973-628-4900
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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 | ANNAMARIE NOVAK
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Credential |
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Telephone | 973-628-4900
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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 | 70A001
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License Number State | NJ
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