Sunrise Third West Bloomfield SL, LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

AH630297112 Issued in MI

Legal business name

SUNRISE THIRD WEST BLOOMFIELD SL, LLC

Doing business as

Sunrise of West Bloomfield

Practice address

7005 Pontiac TRL
West Bloomfield, MI 48323-2181

Phone

(248) 738-8101

Fax

(248) 738-8177

NPI assigned

Apr 29, 2013

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Tamera Kirby

Title

Executive Director

Phone

(248) 738-8101

Specialties & licenses 1

Addresses

Other names 1

• Sunrise of West Bloomfield Doing business as

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1367193600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1367193600000",
    "number": "1093159402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7005 PONTIAC TRL",
            "city": "WEST BLOOMFIELD",
            "state": "MI",
            "postal_code": "483232181",
            "telephone_number": "248-738-8101",
            "fax_number": "248-738-8177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7005 PONTIAC TRL",
            "city": "WEST BLOOMFIELD",
            "state": "MI",
            "postal_code": "483232181",
            "telephone_number": "248-738-8101",
            "fax_number": "248-738-8177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUNRISE THIRD WEST BLOOMFIELD SL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-04-29",
        "last_updated": "2013-04-29",
        "status": "A",
        "authorized_official_last_name": "KIRBY",
        "authorized_official_first_name": "TAMERA",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "248-738-8101"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "MI",
            "license": "AH630297112",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sunrise of West Bloomfield",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Assisted Living Facility in West Bloomfield, MI
• Providers in West Bloomfield, MI by specialty
• Assisted Living Facility in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.