Healthcare Provider Details

I. General information

NPI: 1538826482
Provider Name (Legal Business Name): SUNRISE COMMUNITY SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/25/2021
Last Update Date: 04/18/2024
Certification Date: 04/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1445 ROUTE 130 STE 5
NORTH BRUNSWICK NJ
08902-3100
US

IV. Provider business mailing address

1445 ROUTE 130 STE 5
NORTH BRUNSWICK NJ
08902-3100
US

V. Phone/Fax

Practice location:
  • Phone: 856-446-4939
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code311ZA0620X
TaxonomyAdult Care Home Facility
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code315P00000X
TaxonomyIntellectual Disabilities Intermediate Care Facility
License Number
License Number StateNULL
# 3
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name: AJAY PATEL
Title or Position: DIRECTOR
Credential:
Phone: 732-331-6544