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General NPI Number Information
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NPI Number | 1659212579
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Entity Type | Organization
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Legal Business Name | SUNRISE DETOX TOMS RIVER NJ, 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 | 16 WHITESVILLE RD STE A
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City | TOMS RIVER
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State | NJ
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Zip | 08753-4105
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Country | US
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Telephone | 732-797-2505
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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 | MATHIAS DEUTSCH
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Credential |
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Telephone | 732-684-4749
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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Taxonomy #2
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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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