Provider Demographics
NPI:1093038853
Name:SUNRISE HOME HEALTH CARE SERVICES, INC.
Entity Type:Organization
Organization Name:SUNRISE HOME HEALTH CARE SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:RAY
Authorized Official - Last Name:DODSON
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:219-738-2000
Mailing Address - Street 1:1459 E 84TH PL
Mailing Address - Street 2:
Mailing Address - City:MERRILLVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46410-6451
Mailing Address - Country:US
Mailing Address - Phone:219-738-2000
Mailing Address - Fax:219-738-2005
Practice Address - Street 1:1459 E 84TH PL
Practice Address - Street 2:
Practice Address - City:MERRILLVILLE
Practice Address - State:IN
Practice Address - Zip Code:46410-6451
Practice Address - Country:US
Practice Address - Phone:219-738-2000
Practice Address - Fax:219-738-2005
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-09
Last Update Date:2010-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
INPENDING251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health