Provider Demographics
NPI:1164602314
Name:SUN RISE REHAB LLC
Entity Type:Organization
Organization Name:SUN RISE REHAB LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:TAHIR
Authorized Official - Middle Name:
Authorized Official - Last Name:MAHMOOD
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:301-446-2488
Mailing Address - Street 1:7249 HANOVER PKWY
Mailing Address - Street 2:SUITE A
Mailing Address - City:GREENBELT
Mailing Address - State:MD
Mailing Address - Zip Code:20770-3608
Mailing Address - Country:US
Mailing Address - Phone:301-446-2488
Mailing Address - Fax:301-446-2490
Practice Address - Street 1:7249 HANOVER PKWY
Practice Address - Street 2:SUITE A
Practice Address - City:GREENBELT
Practice Address - State:MD
Practice Address - Zip Code:20770-3608
Practice Address - Country:US
Practice Address - Phone:301-446-2488
Practice Address - Fax:301-446-2490
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-05
Last Update Date:2016-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation