Provider Demographics
NPI:1265453195
Name:SUNRISE HOUSE, INC.
Entity Type:Organization
Organization Name:SUNRISE HOUSE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:TERRI
Authorized Official - Middle Name:
Authorized Official - Last Name:WHITNEY
Authorized Official - Suffix:
Authorized Official - Credentials:CEAP, CCS, CAS
Authorized Official - Phone:925-825-7049
Mailing Address - Street 1:135 MASON CIR STE M
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:CA
Mailing Address - Zip Code:94520-1258
Mailing Address - Country:US
Mailing Address - Phone:925-825-7049
Mailing Address - Fax:925-825-4305
Practice Address - Street 1:135 MASON CIR STE M
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:CA
Practice Address - Zip Code:94520-1258
Practice Address - Country:US
Practice Address - Phone:925-825-7049
Practice Address - Fax:925-825-4305
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility