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General NPI Number Information
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NPI Number | 1225212426
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Entity Type | Organization
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Legal Business Name | SUN STREET CENTERS
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Dates
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Enumeration Date | 12/24/2007
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Last Update Date | 12/11/2025
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Provider Practice Location Address
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Address Line | 11 PEACH DR
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City | SALINAS
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State | CA
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Zip | 93901-3710
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Country | US
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Telephone | 831-753-5135
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Fax |
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Provider Business Mailing Address
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Address Line | 11 PEACH DR
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City | SALINAS
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State | CA
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Zip | 93901-3710
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Country | US
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Telephone | 831-809-8176
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Fax | 831-759-2269
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Authorized Official
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Title or Position | CLINICAL SUPERVISOR II
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Name | MR. GORDON WILLIAM HORNE
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Credential | LAADC #LCI0170115
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Telephone | 808-295-8982
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number | 270003AN
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License Number State | CA
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