Provider Demographics
NPI:1831815950
Name:SUNRISE ADHC LLC
Entity type:Organization
Organization Name:SUNRISE ADHC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:AKINSIJI
Authorized Official - Middle Name:
Authorized Official - Last Name:TAIWO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:857-250-5123
Mailing Address - Street 1:72 FRENCH ST
Mailing Address - Street 2:
Mailing Address - City:PAWTUCKET
Mailing Address - State:RI
Mailing Address - Zip Code:02860-4212
Mailing Address - Country:US
Mailing Address - Phone:857-250-5123
Mailing Address - Fax:
Practice Address - Street 1:845 N MAIN ST
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02904-5700
Practice Address - Country:US
Practice Address - Phone:857-250-5123
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-19
Last Update Date:2022-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care