Provider Demographics
NPI: | 1477792463 |
---|---|
Name: | SUNRISE CARE, LLC |
Entity Type: | Organization |
Organization Name: | SUNRISE CARE, LLC |
Other - Org Name: | MOUNT PLEASANT CARE |
Other - Org Type: | Doing Business As |
Authorized Official - Title/Position: | PRESIDENT |
Authorized Official - Prefix: | MR |
Authorized Official - First Name: | MOHAMMAD |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | SALEEM |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 973-483-1119 |
Mailing Address - Street 1: | 155-157 MOUNT PLEASANT AVE |
Mailing Address - Street 2: | |
Mailing Address - City: | NEWARK |
Mailing Address - State: | NJ |
Mailing Address - Zip Code: | 07104-3963 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 973-483-1119 |
Mailing Address - Fax: | 973-483-7477 |
Practice Address - Street 1: | 155-157 MOUNT PLEASANT AVE |
Practice Address - Street 2: | |
Practice Address - City: | NEWARK |
Practice Address - State: | NJ |
Practice Address - Zip Code: | 07104-3963 |
Practice Address - Country: | US |
Practice Address - Phone: | 973-483-1119 |
Practice Address - Fax: | 973-483-7477 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2009-02-13 |
Last Update Date: | 2009-02-13 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 261QM0801X | Ambulatory Health Care Facilities | Clinic/Center | Mental Health (Including Community Mental Health Center) |