Provider Demographics
NPI:1790936359
Name:SUNRAY TREATMENT AND RECOVERY
Entity Type:Organization
Organization Name:SUNRAY TREATMENT AND RECOVERY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF ADMISSIONS
Authorized Official - Prefix:MS
Authorized Official - First Name:EILEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:AUSTIN
Authorized Official - Suffix:
Authorized Official - Credentials:CADC-II
Authorized Official - Phone:949-373-1050
Mailing Address - Street 1:1450 N EL CAMINO REAL
Mailing Address - Street 2:SUITE C
Mailing Address - City:SAN CLEMENTE
Mailing Address - State:CA
Mailing Address - Zip Code:92672-5909
Mailing Address - Country:US
Mailing Address - Phone:949-373-1050
Mailing Address - Fax:949-373-1054
Practice Address - Street 1:1922 POTTERY AVE
Practice Address - Street 2:
Practice Address - City:PORT ORCHARD
Practice Address - State:WA
Practice Address - Zip Code:98366
Practice Address - Country:US
Practice Address - Phone:253-851-1988
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:RT REAL ESTATE INVESTMENTS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-10-01
Last Update Date:2009-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA18141700261QR0405X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder