Provider Demographics
NPI:1134381338
Name:SUNRISE HOUSE PROGRAM
Entity type:Organization
Organization Name:SUNRISE HOUSE PROGRAM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:
Authorized Official - Last Name:CINELLI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:925-229-2318
Mailing Address - Street 1:2309 PLATT DR
Mailing Address - Street 2:
Mailing Address - City:MARTINEZ
Mailing Address - State:CA
Mailing Address - Zip Code:94553-5018
Mailing Address - Country:US
Mailing Address - Phone:925-229-2318
Mailing Address - Fax:
Practice Address - Street 1:2309 PLATT DR
Practice Address - Street 2:
Practice Address - City:MARTINEZ
Practice Address - State:CA
Practice Address - Zip Code:94553-5018
Practice Address - Country:US
Practice Address - Phone:925-229-2318
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BI-BETT
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-06-28
Last Update Date:2008-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility