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General NPI Number Information
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NPI Number | 1932341088
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Entity Type | Organization
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Legal Business Name | SUNRISE RECOVERY CENTER
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Dates
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Enumeration Date | 04/02/2009
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Last Update Date | 04/02/2009
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Provider Practice Location Address
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Address Line | 119 POPLAR ST
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City | STERLING
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State | CO
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Zip | 80751-4325
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Country | US
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Telephone | 970-522-5522
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Fax | 970-522-5533
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Provider Business Mailing Address
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Address Line | 119 POPLAR ST
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City | STERLING
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State | CO
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Zip | 80751-4325
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Country | US
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Telephone | 970-522-5522
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Fax | 970-522-5533
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Authorized Official
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Title or Position | CLINICAL DIRECTOR
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Name | MS. SUNY STAMPS
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Credential | BA, CAC III
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Telephone | 970-522-5522
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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 | 160601
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License Number State | CO
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