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General NPI Number Information
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NPI Number | 1881008597
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Entity Type | Organization
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Legal Business Name | SUNRISE CHILDREN'S SERVICES, INC.
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Dates
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Enumeration Date | 06/20/2014
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Last Update Date | 10/25/2022
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Provider Practice Location Address
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Address Line | 1925 FREDERICA ST STE 200
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City | OWENSBORO
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State | KY
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Zip | 42301
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Country | US
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Telephone | 270-926-2484
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Fax | 270-685-6015
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Provider Business Mailing Address
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Address Line | PO BOX 1429
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City | MT WASHINGTON
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State | KY
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Zip | 40047-1429
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Country | US
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Telephone | 502-538-1000
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Fax | 502-538-1100
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Authorized Official
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Title or Position | EXECUTIVE ASSISTANT TO PRESIDENT
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Name | SHARON C' DE BACA
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Credential |
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Telephone | 502-538-1010
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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