Provider Demographics
NPI:1851702427
Name:SUNRISE HOUSE FOUNDATION, INC.
Entity Type:Organization
Organization Name:SUNRISE HOUSE FOUNDATION, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:J
Authorized Official - Last Name:KITTEL
Authorized Official - Suffix:
Authorized Official - Credentials:CPA
Authorized Official - Phone:973-383-6300
Mailing Address - Street 1:PO BOX 600
Mailing Address - Street 2:37 SUNSET INN ROAD
Mailing Address - City:LAFAYETTE
Mailing Address - State:NJ
Mailing Address - Zip Code:07848
Mailing Address - Country:US
Mailing Address - Phone:973-383-6300
Mailing Address - Fax:973-383-6929
Practice Address - Street 1:1122 ROUTE 22
Practice Address - Street 2:SUITE 204
Practice Address - City:MOUNTAINSIDE
Practice Address - State:NJ
Practice Address - Zip Code:07092
Practice Address - Country:US
Practice Address - Phone:973-383-6300
Practice Address - Fax:973-383-6929
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-16
Last Update Date:2014-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ2000354261QR0405X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder