Healthcare Provider Details

I. General information

NPI: 1811721269
Provider Name (Legal Business Name): SUNRISE ADH CHELSEA, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/28/2024
Last Update Date: 08/28/2024
Certification Date: 08/28/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

125 LIBRARY ST
CHELSEA MA
02150-3301
US

IV. Provider business mailing address

125 LIBRARY ST
CHELSEA MA
02150-3301
US

V. Phone/Fax

Practice location:
  • Phone: 857-776-6200
  • Fax:
Mailing address:
  • Phone: 857-776-6200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MS. DAWN P KELSEY
Title or Position: LEGAL
Credential: ESQ
Phone: 603-475-3544