Provider Demographics
NPI:1376160945
Name:SUNRISE OUTREACH SOLUTIONS
Entity Type:Organization
Organization Name:SUNRISE OUTREACH SOLUTIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:NATHAN
Authorized Official - Middle Name:L
Authorized Official - Last Name:CHENNAULT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:870-466-4754
Mailing Address - Street 1:PO BOX 622
Mailing Address - Street 2:
Mailing Address - City:SHERIDAN
Mailing Address - State:AR
Mailing Address - Zip Code:72150-0622
Mailing Address - Country:US
Mailing Address - Phone:870-466-4754
Mailing Address - Fax:
Practice Address - Street 1:7500 DOLLARWAY RD STE 401
Practice Address - Street 2:
Practice Address - City:WHITE HALL
Practice Address - State:AR
Practice Address - Zip Code:71602-3083
Practice Address - Country:US
Practice Address - Phone:870-466-4754
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-30
Last Update Date:2020-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty