Provider Demographics
NPI:1508183666
Name:SUNRISE CLINICAL ASSOCIATES, PLLC
Entity Type:Organization
Organization Name:SUNRISE CLINICAL ASSOCIATES, PLLC
Other - Org Name:SUNRISE HOME CARE SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:ANYA
Authorized Official - Middle Name:
Authorized Official - Last Name:ODIM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-493-5013
Mailing Address - Street 1:3326 DURHAM CHAPEL HILL BLVD
Mailing Address - Street 2:SUITE C-100
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27707-6239
Mailing Address - Country:US
Mailing Address - Phone:919-493-5013
Mailing Address - Fax:919-493-5026
Practice Address - Street 1:3326 DURHAM CHAPEL HILL BLVD
Practice Address - Street 2:SUITE C-100
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27707-6239
Practice Address - Country:US
Practice Address - Phone:919-493-5013
Practice Address - Fax:919-493-5026
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SUNRISE CLINICAL ASSOCIATES, PLLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-04-29
Last Update Date:2010-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHC4078251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health