Provider Demographics
NPI:1497397368
Name:SUNRISE ADULT FAMILY HOME CARE
Entity Type:Organization
Organization Name:SUNRISE ADULT FAMILY HOME CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:ARLENA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:FICKETT
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:207-271-8885
Mailing Address - Street 1:PO BOX 571
Mailing Address - Street 2:
Mailing Address - City:JONESPORT
Mailing Address - State:ME
Mailing Address - Zip Code:04649-0571
Mailing Address - Country:US
Mailing Address - Phone:207-271-8885
Mailing Address - Fax:
Practice Address - Street 1:11 OCEAN ST
Practice Address - Street 2:
Practice Address - City:JONESPORT
Practice Address - State:ME
Practice Address - Zip Code:04649-3376
Practice Address - Country:US
Practice Address - Phone:207-271-8885
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-12
Last Update Date:2019-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility