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General NPI Number Information
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NPI Number | 1821550807
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Entity Type | Organization
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Legal Business Name | SUNSTONE RECOVERY LLC
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Dates
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Enumeration Date | 04/01/2019
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Last Update Date | 04/01/2019
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Provider Practice Location Address
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Address Line | 625 NW COLORADO AVE
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City | BEND
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State | OR
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Zip | 97701
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Country | US
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Telephone | 888-888-8888
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Fax |
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Provider Business Mailing Address
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Address Line | 625 NW COLORADO AVE
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City | BEND
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State | OR
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Zip | 97701
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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 | CEO
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Name | LINDSEY BOONE
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Credential | LMFT
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Telephone | 888-888-8888
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/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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Taxonomy #3
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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 #4
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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