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NPI Code Detail

MEDICARE: SUN BEHAVIORAL DELAWARE, LLC

MEDICARE: SUN BEHAVIORAL DELAWARE, LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1251S00000XCommunity/Behavioral Health Agency
2363LP0808XPsychiatric/Mental Health Nurse Practitioner
3283Q00000XPsychiatric Hospital

General Provider Information

NPI Number : 1891213179
Entity Type Code : Organization
Provider Name (Legal Business Name) : SUN BEHAVIORAL DELAWARE, LLC
Provider Business Mailing Address
First Line : PO BOX 4394
Second Line :
City : BRICK
State : NJ
Zip : 08723-0016
Country : US
Telephone Number : 732-747-1800
Fax Number : 732-747-1818
Provider Business Practice Location Address
First Line : 21655 BIDEN AVE
Second Line :
City : GEORGETOWN
State : DE
Zip : 19947-4573
Country : US
Telephone Number : 732-747-1800
Fax Number : 732-747-1818
Authorized Official
Title or Position : SENIOR VICE PRESIDENT CORPORATE DEV
Name : TOM ROURKE
Credential :
Telephone Number : 972-467-4461
Provider Enumeration Date : 09/06/2017
Last Update Date : 01/23/2025

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