Healthcare Provider Details

I. General information

NPI: 1891007118
Provider Name (Legal Business Name): SUNRISE-AMANECER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/02/2010
Last Update Date: 08/11/2011
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 TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number
License Number State

VIII. Authorized Official

Name: DR. VERONICA M NAVARRETE
Title or Position: PSYCHOLOGIST / PRESIDENT, CEO
Credential: PH.D.
Phone: 413-781-3727