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NPI Code Detail

MEDICARE: SUNRISE TREATMENT CENTER, LLC

MEDICARE: SUNRISE TREATMENT CENTER, LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QM0850XAdult Mental Health Clinic/Center
2324500000XSubstance Abuse Rehabilitation Facility
3261QR0405XSubstance Use Disorder Rehabilitation Clinic/Center

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1053067439
Entity Type Code : Organization
Provider Name (Legal Business Name) : SUNRISE TREATMENT CENTER, LLC
Provider Business Mailing Address
First Line : 6460 HARRISON AVE STE 200
Second Line :
City : CINCINNATI
State : OH
Zip : 45247-7821
Country : US
Telephone Number : 513-941-4999
Fax Number :
Provider Business Practice Location Address
First Line : 100 HIGHVIEW BLVD
Second Line :
City : COLUMBUS
State : OH
Zip : 43207-6023
Country : US
Telephone Number : 513-941-4999
Fax Number :
Authorized Official
Title or Position : CREDENTIALING MANAGER
Name : NICHOLE LAIR
Credential :
Telephone Number : 513-941-4999
Provider Enumeration Date : 02/24/2022
Last Update Date : 06/03/2026

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Directions to “SUNRISE TREATMENT CENTER, LLC ” Practice Location

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