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General NPI Number Information
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NPI Number | 1528247095
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Entity Type | Organization
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Legal Business Name | SUNRISE POINT
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Dates
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Enumeration Date | 10/31/2007
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Last Update Date | 10/31/2007
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Provider Practice Location Address
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Address Line | 631 SPENCE ST
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City | BURLINGTON
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State | NC
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Zip | 27217-1271
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Country | US
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Telephone | 336-226-8004
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Fax | 336-226-8088
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Provider Business Mailing Address
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Address Line | 842 NEW JERSEY AVE
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City | BURLINGTON
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State | NC
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Zip | 27217-8891
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Country | US
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Telephone | 336-689-5288
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Fax | 336-226-8088
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Authorized Official
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Title or Position | CEO
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Name | MS. JACQUELINE SELLARS
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Credential |
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Telephone | 336-689-5288
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320800000X
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Taxonomy Name | Mental Illness Community Based Residential Treatment Facility
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License Number | MHL001152
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License Number State | NC
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