Healthcare Provider Details

I. General information

NPI: 1790242675
Provider Name (Legal Business Name): SUNRISE TREATMENT CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/27/2019
Last Update Date: 06/03/2026
Certification Date: 06/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25 WHITNEY DR
MILFORD OH
45150-8402
US

IV. Provider business mailing address

6460 HARRISON AVE STE 200
CINCINNATI OH
45247-7821
US

V. Phone/Fax

Practice location:
  • Phone: 513-941-4999
  • Fax:
Mailing address:
  • Phone: 513-941-4999
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: NICHOLE LAIR
Title or Position: CREDENTIALING MANAGER
Credential:
Phone: 513-941-4999