NPIMap

Organization Active NPI

Sunrise Senior Living Management, Inc.

  • Assisted Living Facility
  • Des Peres, MO
National Provider Identifier
1417112608
Registry record updated Jul 28, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
Legal business name
SUNRISE SENIOR LIVING MANAGEMENT, INC.
Practice address
13460 Manchester Rd
Des Peres, MO 63131-1734
Phone
(314) 965-3800
Fax
(314) 965-3809
NPI assigned
Jul 28, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2008

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

Authorized official

Name
Mr. Tom Brozka
Title
Executive Director
Phone
(314) 965-3800

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X Primary

Addresses

Primary practice location

13460 Manchester Rd
Des Peres, MO 63131-1734

Mailing address

13460 Manchester Rd
Des Peres, MO 63131-1734
Phone (314) 965-3800

Other names 1

  • Sunrise of Des Peres Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
26D2196799Sunrise of Des Peres13460 Manchester Road, Des Peres, MO 63131Certificate of waiverOct 19, 2026

National Provider Directory

National Provider Directory
Tax ID family
Sunrise of Cuyahoga Falls21 organizations share this tax ID, including this one

Other organizations with this tax ID 20

Organizations that report the same tax identification number in the National Provider Directory.

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1217203200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1217203200000",
    "number": "1417112608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13460 MANCHESTER RD",
            "city": "DES PERES",
            "state": "MO",
            "postal_code": "631311734",
            "telephone_number": "314-965-3800",
            "fax_number": "314-965-3809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13460 MANCHESTER RD",
            "city": "DES PERES",
            "state": "MO",
            "postal_code": "631311734",
            "telephone_number": "314-965-3800",
            "fax_number": "314-965-3809"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUNRISE SENIOR LIVING MANAGEMENT, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-28",
        "last_updated": "2008-07-28",
        "status": "A",
        "authorized_official_last_name": "BROZKA",
        "authorized_official_first_name": "TOM",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "314-965-3800",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sunrise of Des Peres",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Des Peres, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.