Healthcare Provider Details

I. General information

NPI: 1154499341
Provider Name (Legal Business Name): SUNRISE COMMUNITY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/04/2006
Last Update Date: 05/27/2020
Certification Date: 05/27/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8430 SW 55TH CT
DAVIE FL
33328-5211
US

IV. Provider business mailing address

8430 SW 55TH CT
DAVIE FL
33328-5211
US

V. Phone/Fax

Practice location:
  • Phone: 954-680-2309
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code315P00000X
TaxonomyIntellectual Disabilities Intermediate Care Facility
License Number
License Number State

VIII. Authorized Official

Name: ANA KARINA GARCIA
Title or Position: ACCOUNTS RECEIVABLE MANAGER
Credential:
Phone: 305-273-3047