Healthcare Provider Details

I. General information

NPI: 1366367013
Provider Name (Legal Business Name): SECOND SUNRISE RECOVERY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/12/2026
Last Update Date: 08/12/2026
Certification Date: 08/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2490 SCARLET RD
GILROY CA
95020-9138
US

IV. Provider business mailing address

1560 KOOSER RD
SAN JOSE CA
95118-3335
US

V. Phone/Fax

Practice location:
  • Phone: 408-337-2187
  • Fax:
Mailing address:
  • Phone: 408-337-2187
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251X00000X
TaxonomySupports Brokerage Agency
License Number
License Number State

VIII. Authorized Official

Name: TERESA LINDERMA LIBERA
Title or Position: MEMBER
Credential:
Phone: 408-337-2187