Provider Demographics
NPI:1073186912
Name:SUNRISE CARE & CONSULTING, LLC
Entity Type:Organization
Organization Name:SUNRISE CARE & CONSULTING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CASE MANAGER/CARE COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:JADETH
Authorized Official - Middle Name:ADREANA
Authorized Official - Last Name:YEPEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MPA, CBHCM
Authorized Official - Phone:321-917-5807
Mailing Address - Street 1:1600 W EAU GALLIE BLVD STE 205P
Mailing Address - Street 2:
Mailing Address - City:MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32935-4149
Mailing Address - Country:US
Mailing Address - Phone:321-917-5807
Mailing Address - Fax:321-574-4116
Practice Address - Street 1:1600 W EAU GALLIE BLVD STE 205P
Practice Address - Street 2:
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32935-4149
Practice Address - Country:US
Practice Address - Phone:321-917-5807
Practice Address - Fax:321-574-4116
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-19
Last Update Date:2023-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251B00000XAgenciesCase Management
Yes171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Single Specialty