Provider Demographics
NPI:1346664067
Name:SUNRISE BEHAVIORAL HEALTH, LLC
Entity Type:Organization
Organization Name:SUNRISE BEHAVIORAL HEALTH, LLC
Other - Org Name:SUNRISE BEHAVIORAL HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER-MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:REGINA
Authorized Official - Middle Name:
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:623-242-6408
Mailing Address - Street 1:9280 W SUNNYSLOPE LN
Mailing Address - Street 2:
Mailing Address - City:PEORIA
Mailing Address - State:AZ
Mailing Address - Zip Code:85345-6308
Mailing Address - Country:US
Mailing Address - Phone:623-242-6408
Mailing Address - Fax:623-242-7158
Practice Address - Street 1:9280 W SUNNYSLOPE LN
Practice Address - Street 2:
Practice Address - City:PEORIA
Practice Address - State:AZ
Practice Address - Zip Code:85345-6308
Practice Address - Country:US
Practice Address - Phone:623-242-6408
Practice Address - Fax:623-242-7158
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-17
Last Update Date:2024-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness