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General NPI Number Information
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NPI Number | 1316342074
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Entity Type | Organization
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Legal Business Name | SUNRISE INSPIRATIONS, PC
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Dates
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Enumeration Date | 10/23/2014
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Last Update Date | 10/23/2014
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Provider Practice Location Address
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Address Line | 208 S BURLINGTON AVE SUITE 106, OFFICE D
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City | HASTINGS
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State | NE
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Zip | 68901
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Country | US
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Telephone | 402-705-2364
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Fax |
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Provider Business Mailing Address
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Address Line | 1019 N SAUNDERS AVE
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City | HASTINGS
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State | NE
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Zip | 68901
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Country | US
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Telephone | 402-705-2364
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MICHELLE SMITH
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Credential | LIMHP
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Telephone | 402-705-2364
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 1201
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License Number State | NE
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