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General NPI Number Information
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NPI Number | 1689595381
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Entity Type | Organization
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Legal Business Name | SECOND SUNRISE RECOVERY LLC
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Dates
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Enumeration Date | 07/21/2026
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Last Update Date | 07/21/2026
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Provider Practice Location Address
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Address Line | 1538 W OSBORN RD
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City | PHOENIX
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State | AZ
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Zip | 85015-5872
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Country | US
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Telephone | 702-427-4537
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Fax |
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Provider Business Mailing Address
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Address Line | 7040 W WINSTON DR
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City | LAVEEN
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State | AZ
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Zip | 85339-5518
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Country | US
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Telephone | 702-427-4537
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Fax |
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Authorized Official
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Title or Position | CLINICAL DIRECTOR
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Name | EBONY CHERISE BRUSHBREAKER
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Credential | PHD, LCSW
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Telephone | 702-427-4537
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health 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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