Provider Demographics
NPI:1942670443
Name:SUNRISE BEHAVIORAL HEALTH CARE LLC
Entity Type:Organization
Organization Name:SUNRISE BEHAVIORAL HEALTH CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MILDRED
Authorized Official - Middle Name:C
Authorized Official - Last Name:FRANCISCO
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:609-571-7427
Mailing Address - Street 1:3100 PRINCETON PIKE
Mailing Address - Street 2:BLDG 3; STE B
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08648-2300
Mailing Address - Country:US
Mailing Address - Phone:609-571-7427
Mailing Address - Fax:973-433-7850
Practice Address - Street 1:3100 PRINCETON PIKE
Practice Address - Street 2:BLDG 3; STE B
Practice Address - City:LAWRENCEVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08648-2300
Practice Address - Country:US
Practice Address - Phone:609-571-7427
Practice Address - Fax:973-433-7850
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-28
Last Update Date:2015-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC054081001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty