Provider Demographics
NPI:1740412097
Name:SUNRISE COMMUNITY INC.
Entity Type:Organization
Organization Name:SUNRISE COMMUNITY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BOARD TREASURER/C.F.O
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:WEEKS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-273-3024
Mailing Address - Street 1:9040 SUNSET DR
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33173-3432
Mailing Address - Country:US
Mailing Address - Phone:305-596-9040
Mailing Address - Fax:305-598-8240
Practice Address - Street 1:4745 NW 7TH CT
Practice Address - Street 2:
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33426-9340
Practice Address - Country:US
Practice Address - Phone:561-547-2220
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-20
Last Update Date:2009-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL024975106Medicaid