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General NPI Number Information
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NPI Number | 1578404505
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Entity Type | Organization
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Legal Business Name | SUNRISE DETOX ALPHARETTA GA, LLC
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Dates
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Enumeration Date | 04/03/2026
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Last Update Date | 04/03/2026
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Provider Practice Location Address
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Address Line | 4500 N POINT PKWY
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City | ALPHARETTA
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State | GA
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Zip | 30022-2409
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Country | US
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Telephone | 678-762-0370
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1575
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City | LAKEWOOD
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State | NJ
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Zip | 08701-1018
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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 | AUTHORIZED OFFICIAL
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Name | YITZCHOK WEINFELD
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Credential |
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Telephone | 917-837-6757
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 324500000X
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Taxonomy Name | Substance Abuse Rehabilitation Facility
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License Number |
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License Number State |
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