Healthcare Provider Details

I. General information

NPI: 1689595381
Provider Name (Legal Business Name): SECOND SUNRISE RECOVERY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/21/2026
Last Update Date: 07/21/2026
Certification Date: 07/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1538 W OSBORN RD
PHOENIX AZ
85015-5872
US

IV. Provider business mailing address

7040 W WINSTON DR
LAVEEN AZ
85339-5518
US

V. Phone/Fax

Practice location:
  • Phone: 702-427-4537
  • Fax:
Mailing address:
  • Phone: 702-427-4537
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: EBONY CHERISE BRUSHBREAKER
Title or Position: CLINICAL DIRECTOR
Credential: PHD, LCSW
Phone: 702-427-4537