Provider Demographics
NPI:1366642696
Name:SUNRISE HOME HEALTH CARE, LLC
Entity Type:Organization
Organization Name:SUNRISE HOME HEALTH CARE, LLC
Other - Org Name:SUNRISE HOME HEALTH & HOSPICE, LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:
Authorized Official - Last Name:BAKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-374-6553
Mailing Address - Street 1:1561 GRANDVIEW LN
Mailing Address - Street 2:
Mailing Address - City:PROVO
Mailing Address - State:UT
Mailing Address - Zip Code:84604-1019
Mailing Address - Country:US
Mailing Address - Phone:801-374-6553
Mailing Address - Fax:801-374-2323
Practice Address - Street 1:1561 GRANDVIEW LN
Practice Address - Street 2:
Practice Address - City:PROVO
Practice Address - State:UT
Practice Address - Zip Code:84604-1019
Practice Address - Country:US
Practice Address - Phone:801-374-6553
Practice Address - Fax:801-374-2323
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-24
Last Update Date:2015-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based