Provider Demographics
NPI:1760411516
Name:SUNRISE HOME CARE, INC
Entity Type:Organization
Organization Name:SUNRISE HOME CARE, INC
Other - Org Name:WELLNESS HOME CARE OF MICHIGAN
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:KAVITA
Authorized Official - Middle Name:
Authorized Official - Last Name:SURYAVANSHI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:810-245-1900
Mailing Address - Street 1:404 W NEPESSING ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:LAPEER
Mailing Address - State:MI
Mailing Address - Zip Code:48446-2150
Mailing Address - Country:US
Mailing Address - Phone:810-245-1900
Mailing Address - Fax:810-245-9080
Practice Address - Street 1:404 W NEPESSING ST
Practice Address - Street 2:SUITE B
Practice Address - City:LAPEER
Practice Address - State:MI
Practice Address - Zip Code:48446-2150
Practice Address - Country:US
Practice Address - Phone:810-245-1900
Practice Address - Fax:810-245-9080
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI35469Medicaid
MI01003148Medicaid
MI1017109Medicaid
MI35469Medicaid