Healthcare Provider Details

I. General information

NPI: 1346577202
Provider Name (Legal Business Name): SUNRISE DETOX II
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/12/2009
Last Update Date: 10/05/2023
Certification Date: 10/05/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1272 LONG HILL RD
STIRLING NJ
07980-1010
US

IV. Provider business mailing address

1272 LONG HILL RD
STIRLING NJ
07980-1010
US

V. Phone/Fax

Practice location:
  • Phone: 908-504-2700
  • Fax:
Mailing address:
  • Phone: 908-504-2700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code320800000X
TaxonomyMental Illness Community Based Residential Treatment Facility
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code276400000X
TaxonomySubstance Use Disorder Rehabilitation Hospital Unit
License Number1000103
License Number StateNJ

VIII. Authorized Official

Name: MRS. LINDA R BURNS
Title or Position: CHIEF NURSE OFFICER
Credential: RN
Phone: 561-951-8341