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General NPI Number Information
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NPI Number | 1417444399
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Entity Type | Organization
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Legal Business Name | SUNRISE TREATMENT CENTER, LLC
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Dates
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Enumeration Date | 04/17/2018
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Last Update Date | 06/03/2024
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Provider Practice Location Address
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Address Line | 160 N BREIEL BLVD
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City | MIDDLETOWN
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State | OH
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Zip | 45042-3806
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Country | US
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Telephone | 513-941-4999
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Fax | 513-941-7555
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Provider Business Mailing Address
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Address Line | 6460 HARRISON AVE. SUITE 200
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City | CINCINNATI
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State | OH
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Zip | 45247-7958
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Country | US
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Telephone | 513-467-2825
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Fax | 513-941-7555
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Authorized Official
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Title or Position | CONTRACT & PROVIDER RELATIONS MGR.
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Name | RANDY SPAULDING
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Credential |
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Telephone | 513-467-2825
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QR0405X
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Taxonomy Name | Substance Use Disorder Rehabilitation Clinic/Center
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License Number |
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License Number State |
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