SJV 1 Raleigh Opco LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

SJV 1 RALEIGH OPCO LLC

Practice address

4801 Edwards Mill Rd
Raleigh, NC 27612-4417

Phone

(919) 787-0777

Fax

(919) 787-6105

NPI assigned

Feb 11, 2021

Organization subpart

No

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

Authorized official

Name

Michelle Minor

Title

Director of Operation

Phone

(919) 787-0777

Specialties & licenses 1

Addresses

Other names 1

• Sunrise of Raleigh Doing business as

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

{
    "created_epoch": "1613001600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1613001600000",
    "number": "1215529110",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4801 EDWARDS MILL RD",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276124417",
            "telephone_number": "919-787-0777",
            "fax_number": "919-787-6105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4801 EDWARDS MILL RD",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276124417",
            "telephone_number": "919-787-0777",
            "fax_number": "919-787-6105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SJV 1 RALEIGH OPCO LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-02-11",
        "last_updated": "2021-02-11",
        "certification_date": "2021-02-11",
        "status": "A",
        "authorized_official_last_name": "MINOR",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_title_or_position": "DIRECTOR OF OPERATION",
        "authorized_official_telephone_number": "919-787-0777"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sunrise of Raleigh",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Assisted Living Facility in Raleigh, NC
• Providers in Raleigh, NC by specialty
• Assisted Living Facility in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2021; 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.