Provider Demographics
NPI:1073168738
Name:SUN BEHAVIORAL DELAWARE, LLC
Entity Type:Organization
Organization Name:SUN BEHAVIORAL DELAWARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SVP CORPORATE DEVELOPMENT
Authorized Official - Prefix:
Authorized Official - First Name:TOM
Authorized Official - Middle Name:
Authorized Official - Last Name:ROURKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-467-4461
Mailing Address - Street 1:12 BROAD ST STE 403
Mailing Address - Street 2:
Mailing Address - City:RED BANK
Mailing Address - State:NJ
Mailing Address - Zip Code:07701-1938
Mailing Address - Country:US
Mailing Address - Phone:972-467-4461
Mailing Address - Fax:732-747-1818
Practice Address - Street 1:21655 BIDEN AVE
Practice Address - Street 2:
Practice Address - City:GEORGETOWN
Practice Address - State:DE
Practice Address - Zip Code:19947-4573
Practice Address - Country:US
Practice Address - Phone:302-604-5600
Practice Address - Fax:302-450-1262
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-08
Last Update Date:2019-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty