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NPI Code Detail

MEDICARE: SUNRISE RECOVERY LLC

MEDICARE: SUNRISE RECOVERY 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
1261QM0801XMental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number : 1972311413
Entity Type Code : Organization
Provider Name (Legal Business Name) : SUNRISE RECOVERY LLC
Provider Business Mailing Address
First Line : 132 E MAIN ST
Second Line :
City : LANCASTER
State : OH
Zip : 43130-3712
Country : US
Telephone Number : 614-404-5923
Fax Number :
Provider Business Practice Location Address
First Line : 132 E MAIN ST
Second Line :
City : LANCASTER
State : OH
Zip : 43130-3712
Country : US
Telephone Number : 614-404-5923
Fax Number :
Authorized Official
Title or Position : OWNER
Name : CIARA COLBERT
Credential : CDCA
Telephone Number : 614-404-5923
Provider Enumeration Date : 12/30/2024
Last Update Date : 12/30/2024

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Directions to “SUNRISE RECOVERY LLC ” Practice Location

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