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General NPI Number Information
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NPI Number | 1376015685
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Entity Type | Organization
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Legal Business Name | SUNRISE ADULT DAY CARE
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Dates
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Enumeration Date | 12/27/2018
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Last Update Date | 12/27/2018
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Provider Practice Location Address
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Address Line | 3930 LEON AVE SUITE # 130
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City | LAS VEGAS
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State | NV
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Zip | 89130
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Country | US
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Telephone | 702-468-9994
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Fax |
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Provider Business Mailing Address
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Address Line | 8866 SANIBEL SHORE AVE
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City | LAS VEGAS
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State | NV
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Zip | 89147-6565
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Country | US
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Telephone | 702-468-9994
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | EUN HEE KIM
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Credential |
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Telephone | 702-468-9994
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA0600X
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Taxonomy Name | Adult Day Care Clinic/Center
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License Number |
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License Number State |
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