Sullivan Ilf Community Healthcare LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

SULLIVAN ILF COMMUNITY HEALTHCARE LLC

Doing business as

Sullivan Park Senior Living

Practice address

411 S Adams Rd
Spokane Valley, WA 99216-2287

Phone

(509) 924-5555

NPI assigned

May 18, 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 Doing business as

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

{
    "created_epoch": "1715990400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1715990400000",
    "number": "1922857119",
    "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": "411 S ADAMS RD",
            "city": "SPOKANE VALLEY",
            "state": "WA",
            "postal_code": "992162287",
            "telephone_number": "509-924-5555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SULLIVAN ILF COMMUNITY HEALTHCARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-05-18",
        "last_updated": "2024-05-18",
        "certification_date": "2024-05-18",
        "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",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Rosemond Marie Styczinski, LMP
• Stephanie Suarez
• Chadd Sukut, MD
• Sullivan Alf Community Healthcare LLC
• Sullivan Cottages, L.L.C.
• Sullivan SNF Healthcare LLC
• Sullivan Ventures LLC
• Geri Mae Sullivan, LPN
• Tammy K. Sullivan, RPH
• Jaclyn Danielle Summers, LMP

• 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 18, 2024; 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.