Sundance Adult Family Home LLC

Primary specialty

Adult Care Home FacilityTaxonomy code 311ZA0620X

Legal business name

SUNDANCE ADULT FAMILY HOME LLC

Doing business as

Sundance Adult Family Home

Practice address

10216 N Sundance Dr
Spokane, WA 99208-9315

Phone

(509) 315-5779

Fax

(509) 984-6291

NPI assigned

Nov 3, 2022

Last updated

Nov 11, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Susan Mwiklai Waweru, RNNPI 1255819967

Title

Manager

Phone

(508) 612-3875

Specialties & licenses 1

Addresses

Other names 1

• Sundance Adult Family Home Doing business as

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

CLIA laboratory certificates

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Susan Waweru

  • Registered Nurse
  • Spokane, WA
  • NPI 1255819967
  NPD Authorized official

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

{
    "created_epoch": "1667433600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1668124800000",
    "number": "1629785159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10216 N SUNDANCE DR",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992089315",
            "telephone_number": "509-315-5779",
            "fax_number": "509-984-6291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10216 N SUNDANCE DR",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992089315",
            "telephone_number": "509-315-5779",
            "fax_number": "509-984-6291"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUNDANCE ADULT FAMILY HOME LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-11-03",
        "last_updated": "2022-11-11",
        "certification_date": "2022-11-11",
        "status": "A",
        "authorized_official_last_name": "WAWERU",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_middle_name": "MWIKLAI",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "508-612-3875",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sundance Adult Family Home",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Sundance Adult Family Home",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Summit Pacific Outpatient Services, LLC
• Summit Pacific Rehabilitation, LLC
• Summit Rehabilitation Associates, PLLC
• Logan Clayton Sumner, MS LAT ATC
• Shanshan Sun, PHARMD
• Sundance Anesthesia LLC
• Mitchel Sundquist
• Sunflower Therapy LLC
• Sunlit Therapeutic Services, PLLC
• Sunny Buns Massage Therapy

• Adult Care Home Facility in Spokane, WA
• Providers in Spokane, WA by specialty
• Adult Care Home Facility in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2022; 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.