Provider Demographics
NPI:1609387117
Name:SUNHOUSE
Entity Type:Organization
Organization Name:SUNHOUSE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:JO
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:RIMMER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:209-479-1536
Mailing Address - Street 1:1781 WILLOW PARK WAY
Mailing Address - Street 2:
Mailing Address - City:STOCKTON
Mailing Address - State:CA
Mailing Address - Zip Code:95206-5832
Mailing Address - Country:US
Mailing Address - Phone:209-479-1536
Mailing Address - Fax:
Practice Address - Street 1:1781 WILLOW PARK WAY
Practice Address - Street 2:
Practice Address - City:STOCKTON
Practice Address - State:CA
Practice Address - Zip Code:95206-5832
Practice Address - Country:US
Practice Address - Phone:209-479-1536
Practice Address - Fax:209-479-1536
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-24
Last Update Date:2017-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty