Provider Demographics
NPI:1609812270
Name:SUNRISE HOME HEALTH SERVICES OF SA, INC
Entity Type:Organization
Organization Name:SUNRISE HOME HEALTH SERVICES OF SA, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:C
Authorized Official - Last Name:LEAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-735-0606
Mailing Address - Street 1:5357 W COMMERCE ST
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78237-1355
Mailing Address - Country:US
Mailing Address - Phone:210-735-0606
Mailing Address - Fax:210-732-7370
Practice Address - Street 1:5357 W COMMERCE ST
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78237-1355
Practice Address - Country:US
Practice Address - Phone:210-735-0606
Practice Address - Fax:210-732-7370
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX007066251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX678319Medicare ID - Type UnspecifiedHOME HEALTH