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General NPI Number Information
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NPI Number | 1295455459
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Entity Type | Organization
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Legal Business Name | SUNRISE MENTAL HEALTH SERVICES, LLC
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Dates
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Enumeration Date | 08/29/2022
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Last Update Date | 09/12/2023
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Provider Practice Location Address
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Address Line | 32 OXFORD DR
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City | NEWINGTON
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State | CT
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Zip | 06111-1823
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Country | US
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Telephone | 860-201-3710
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Fax |
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Provider Business Mailing Address
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Address Line | 900 WASHINGTON ST STE 1012
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City | MIDDLETOWN
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State | CT
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Zip | 06457-2932
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Country | US
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Telephone | 860-201-3710
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Fax |
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Authorized Official
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Title or Position | FOUNDER
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Name | FABIANA ARETUSA SILVA
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Credential | LCSW
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Telephone | 860-201-3710
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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