Healthcare Provider Details

I. General information

NPI: 1881083863
Provider Name (Legal Business Name): SUNRISE RCFE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/14/2015
Last Update Date: 01/14/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

32 N 21ST ST
SAN JOSE CA
95116-1102
US

IV. Provider business mailing address

32 N 21ST ST
SAN JOSE CA
95116-1102
US

V. Phone/Fax

Practice location:
  • Phone: 408-971-4244
  • Fax: 408-418-3675
Mailing address:
  • Phone: 408-971-4244
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number430706162
License Number StateCA

VIII. Authorized Official

Name: VIRGIL VALIN
Title or Position: VICE PRESIDENT
Credential:
Phone: 408-477-5522