Provider Demographics
NPI:1891203261
Name:SUNRISE COMMUNITY MENTAL HEALTH CENTER CORP
Entity Type:Organization
Organization Name:SUNRISE COMMUNITY MENTAL HEALTH CENTER CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ALEIRAM
Authorized Official - Middle Name:
Authorized Official - Last Name:CAGIGAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-436-9597
Mailing Address - Street 1:2311 10TH AVE N
Mailing Address - Street 2:
Mailing Address - City:LAKE WORTH
Mailing Address - State:FL
Mailing Address - Zip Code:33461-6605
Mailing Address - Country:US
Mailing Address - Phone:561-436-9597
Mailing Address - Fax:
Practice Address - Street 1:2311 10TH AVE N
Practice Address - Street 2:
Practice Address - City:LAKE WORTH
Practice Address - State:FL
Practice Address - Zip Code:33461-6605
Practice Address - Country:US
Practice Address - Phone:561-436-9597
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-18
Last Update Date:2018-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health