Sullivan Alf Community Healthcare LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

SULLIVAN ALF COMMUNITY HEALTHCARE LLC

Doing business as

Sullivan Park Senior Living ALF

Practice address

421 S Adams Rd
Spokane Valley, WA 99216-2121

Phone

(360) 837-5876

NPI assigned

May 16, 2024

Organization subpart

No

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

Authorized official

Name

John Mitchell

Title

Secretary

Phone

(801) 447-9829

Specialties & licenses 1

Addresses

Other names 1

• Sullivan Park Senior Living ALF 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

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

{
    "created_epoch": "1715817600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1715817600000",
    "number": "1891544359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "262 N UNIVERSITY AVE",
            "city": "FARMINGTON",
            "state": "UT",
            "postal_code": "840252975"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "421 S ADAMS RD",
            "city": "SPOKANE VALLEY",
            "state": "WA",
            "postal_code": "992162121",
            "telephone_number": "360-837-5876"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SULLIVAN ALF COMMUNITY HEALTHCARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-05-16",
        "last_updated": "2024-05-16",
        "certification_date": "2024-05-16",
        "status": "A",
        "authorized_official_last_name": "MITCHELL",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "801-447-9829"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sullivan Park Senior Living ALF",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Caroline Marie Stuart, PA-C, MPAS, ATC
• Christopher W Sturbaum, MD
• Rosemond Marie Styczinski, LMP
• Stephanie Suarez
• Chadd Sukut, MD
• Sullivan Cottages, L.L.C.
• Sullivan Ilf Community Healthcare LLC
• Sullivan SNF Healthcare LLC
• Sullivan Ventures LLC
• Geri Mae Sullivan, LPN

• Assisted Living Facility in Spokane Valley, WA
• Providers in Spokane Valley, WA by specialty
• Assisted Living Facility in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2024; 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.