Provider Demographics
NPI:1093091274
Name:SUNRISE COMMUNITY OF TENNESSEE, INC.
Entity Type:Organization
Organization Name:SUNRISE COMMUNITY OF TENNESSEE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:WEEKS
Authorized Official - Suffix:
Authorized Official - Credentials:PH D
Authorized Official - Phone:305-273-3024
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:305-593-9040
Mailing Address - Fax:
Practice Address - Street 1:5645 MERCHANTS CENTER BLVD
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37912-3470
Practice Address - Country:US
Practice Address - Phone:931-648-3011
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-01
Last Update Date:2011-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services