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General NPI Number Information
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NPI Number | 1497891691
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Entity Type | Organization
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Legal Business Name | SUNRISE COMMUNITY, INC.
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Dates
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Enumeration Date | 01/29/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 22300 SW 162ND AVE
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City | GOULDS
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State | FL
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Zip | 33170-3907
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Country | US
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Telephone | 305-245-6150
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Fax |
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Provider Business Mailing Address
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Address Line | 22300 SW 162ND AVE
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City | GOULDS
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State | FL
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Zip | 33170-3907
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | BOARD SECRETARY & TREASURER
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Name | DR. JAMES WEEKS
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Credential |
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Telephone | 305-273-3024
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 315P00000X
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Taxonomy Name | Intellectual Disabilities Intermediate Care Facility
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License Number |
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License Number State |
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