Provider Demographics
NPI:1750315461
Name:SUNRISE HOME HEALTH SERVICES OF SAN ANTONIO, INC.
Entity Type:Organization
Organization Name:SUNRISE HOME HEALTH SERVICES OF SAN ANTONIO, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO - PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:
Authorized Official - Last Name:LEAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-735-0606
Mailing Address - Street 1:1825 W OLMOS DR
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78201-4016
Mailing Address - Country:US
Mailing Address - Phone:210-735-0606
Mailing Address - Fax:210-732-7370
Practice Address - Street 1:1825 W OLMOS DR
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78201-4016
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:2006-07-10
Last Update Date:2012-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX007066251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX678319Medicare Oscar/Certification