SUNSET PARK PLACE CO NPI 1114137601

NPI Information

NPI: 1114137601
Provider Name: SUNSET PARK PLACE CO
Classification: Assisted Living Facility - 310400000X
Entity Type: Organization

CLIA Number: 16D1064977

Address:
3730 PENNSYLVANIA AVE
DUBUQUE, IA
ZIP 52002
Phone: (563) 583-7939
Get Directions

SUNSET PARK PLACE CO is an assisted living facility in Dubuque, IA. The provider is a facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being. SUNSET PARK PLACE CO NPI is 1114137601. The provider is registered as an organization entity type.

The provider's business location address is:

3730 PENNSYLVANIA AVE
DUBUQUE, IA
ZIP 52002-701
Phone: (563) 583-7939
Fax: (563) 583-2982

The provider's authorized official is Jerry Bell .
The authorized official title is Manager and has the following contact phone number (563) 583-7939.

The CLIA number assigned to this NPI record is 16D1064977 - assisted living facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/23/2007 and was last updated on 8/22/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	310400000X	Assisted Living Facility		S0127	IOWA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	0478701	MEDICAID	IOWA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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