Provider Demographics
NPI:1780633933
Name:SUNRISE HOME CARE SERVICES, INC
Entity Type:Organization
Organization Name:SUNRISE HOME CARE SERVICES, INC
Other - Org Name:SUNRISE HOME CARE, INC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT/ CEO
Authorized Official - Prefix:
Authorized Official - First Name:RAMONA
Authorized Official - Middle Name:OLIVIA
Authorized Official - Last Name:MOLINA -VEGA
Authorized Official - Suffix:
Authorized Official - Credentials:REGISTERED NURSE
Authorized Official - Phone:626-289-4200
Mailing Address - Street 1:941 S ATLANTIC BLVD STE 222
Mailing Address - Street 2:
Mailing Address - City:MONTEREY PARK
Mailing Address - State:CA
Mailing Address - Zip Code:91754-4722
Mailing Address - Country:US
Mailing Address - Phone:626-289-4200
Mailing Address - Fax:626-289-4201
Practice Address - Street 1:941 S ATLANTIC BLVD STE 222
Practice Address - Street 2:
Practice Address - City:MONTEREY PARK
Practice Address - State:CA
Practice Address - Zip Code:91754
Practice Address - Country:US
Practice Address - Phone:626-289-4200
Practice Address - Fax:626-289-4201
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-07
Last Update Date:2019-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA9800001483251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA058200Medicare Oscar/Certification