SUNSET LAKE VILLAGE
NPI 1285078659
Assisted Living Facility in Venice, FL

Q: What is Nic 4 Sunset Lake Leasing's NPI number?

The NPI number for Nic 4 Sunset Lake Leasing is 1285078659. It was assigned to this organization in the NPPES registry on April 29, 2013. The provider is doing business as Sunset Lake Village.

Q: What is Nic 4 Sunset Lake Leasing's specialty?

The primary specialty registered for this NPI is Assisted Living Facility with taxonomy code 310400000X.

Active since April 29, 2013

1121 JACARANDA BLVD., VENICE, FL 34292(941) 497-1117(941) 492-3455 Get Directions Write a Review

NPPES record last updated: December 1, 2016. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Sunset Lake Village NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SUNSET LAKE VILLAGE (NPI 1285078659) is a healthcare organization registered as an assisted living facility in Venice, Florida and active in the NPI registry since April 2013. The organization lists Jane Ryu, President/ceo/cfo, as its authorized official.

NPPES Registry Identity

NPI1285078659

Entity TypeOrganization

Primary Taxonomy310400000X

Legal Business NameNIC 4 SUNSET LAKE LEASING

Location Address1121 JACARANDA BLVD.Venice, FL 34292

Mailing AddressC/o Holiday Retirement, Po Box 1700, Nic 4 Sunset Lake LeasingLake Oswego, OR 97035 · (971) 245-8020 · Fax (503) 431-2295

Phone(941) 497-1117

Fax(941) 492-3455

Organization SubpartNo

Authorized OfficialJane RyuPresident/ceo/cfo · (212) 479-5270

Enumeration DateApril 29, 2013

Last NPPES UpdateDecember 1, 2016

✔ NPI 1285078659 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyAssisted Living FacilityNursing & Custodial Care Facilities

Taxonomy Code310400000X

License✔ Licensed in FL · 9325

Definition

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.

1121 JACARANDA BLVD., Venice, FL 34292

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Other Names 1

Doing Business AsSunset Lake Village

Other Identifiers 1

Other003067300FL · Medicaid Aged/disabled Adults

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Nic 4 Sunset Lake Leasing's NPI number?

The NPI number for Nic 4 Sunset Lake Leasing is 1285078659. It was assigned to this organization in the NPPES registry on April 29, 2013. The provider is doing business as Sunset Lake Village.

Where is Nic 4 Sunset Lake Leasing located?

Nic 4 Sunset Lake Leasing is located at 1121 Jacaranda Blvd., Venice, FL 34292. The listed phone number is (941) 497-1117.

What is Nic 4 Sunset Lake Leasing's specialty?

The primary specialty registered for this NPI is Assisted Living Facility with taxonomy code 310400000X.

When was this NPI record last updated?

The NPPES record for Nic 4 Sunset Lake Leasing was last updated on December 1, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.