Healthcare Provider Details

I. General information

NPI: 1063966687
Provider Name (Legal Business Name): SUNRISE-AMANECER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/11/2016
Last Update Date: 08/11/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19 MILFORD ST
SPRINGFIELD MA
01107-1332
US

IV. Provider business mailing address

19 MILFORD ST
SPRINGFIELD MA
01107-1332
US

V. Phone/Fax

Practice location:
  • Phone: 413-781-3727
  • Fax: 413-734-8192
Mailing address:
  • Phone: 413-781-3727
  • Fax: 413-734-8192

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: DR. VERONICA NAVARRETE-VIVERO
Title or Position: CEO
Credential: PH.D., MS
Phone: 413-781-3727