Healthcare Provider Details

I. General information

NPI: 1417781840
Provider Name (Legal Business Name): RISING SUN ADULT DAY HEALTHCARE, INC
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

490 BOSTON POST RD
SUDBURY MA
01776-3367
US

IV. Provider business mailing address

490 BOSTON POST RD
SUDBURY MA
01776-3367
US

V. Phone/Fax

Practice location:
  • Phone: 323-854-0678
  • Fax:
Mailing address:
  • Phone: 323-854-0678
  • 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: MRS. INNA PROSHAK
Title or Position: OWNER
Credential:
Phone: 323-854-0678