Provider Demographics
NPI:1003517798
Name:SUNRISE COMMUNITY OF IOWA INC
Entity Type:Organization
Organization Name:SUNRISE COMMUNITY OF IOWA INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT & CEO
Authorized Official - Prefix:
Authorized Official - First Name:ZACH
Authorized Official - Middle Name:
Authorized Official - Last Name:WRAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-273-3011
Mailing Address - Street 1:9040 SUNSET DR
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33173-3432
Mailing Address - Country:US
Mailing Address - Phone:305-596-9040
Mailing Address - Fax:
Practice Address - Street 1:505 5TH AVE STE 729
Practice Address - Street 2:
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50309-2318
Practice Address - Country:US
Practice Address - Phone:305-596-9040
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-10
Last Update Date:2023-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services