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NPI Code Detail

MEDICARE: SUNSET MANOR, INC.

MEDICARE: SUNSET MANOR, INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1314000000XSkilled Nursing Facility414030MI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1154324754
Entity Type Code : Organization
Provider Name (Legal Business Name) : SUNSET MANOR, INC.
Provider Business Mailing Address
First Line : 3400 WILSON AVE SW
Second Line :
City : GRANDVILLE
State : MI
Zip : 49418-1854
Country : US
Telephone Number : 616-534-5487
Fax Number : 616-534-2150
Provider Business Practice Location Address
First Line : 3400 WILSON AVE SW
Second Line :
City : GRANDVILLE
State : MI
Zip : 49418-1854
Country : US
Telephone Number : 616-534-5487
Fax Number : 616-534-2150
Authorized Official
Title or Position : EXECUTIVE DIRECTOR - BROOKCREST
Name : MS. LORI HERBIG
Credential :
Telephone Number : 616-534-5487
Provider Enumeration Date : 05/27/2005
Last Update Date : 08/22/2020

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Directions to “SUNSET MANOR, INC. ” Practice Location

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