Basic Information
| Provider Information | |||||||||
| NPI: | 1093091274 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | SUNRISE COMMUNITY OF TENNESSEE, INC. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 9040 SUNSET DR | ||||||||
| Address2: | |||||||||
| City: | MIAMI | ||||||||
| State: | FL | ||||||||
| PostalCode: | 331733432 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3055939040 | ||||||||
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| Practice Location | |||||||||
| Address1: | 5645 MERCHANTS CENTER BLVD | ||||||||
| Address2: | |||||||||
| City: | KNOXVILLE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 379123470 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9316483011 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 11/01/2011 | ||||||||
| LastUpdateDate: | 11/01/2011 | ||||||||
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| AuthorizedOfficialLastName: | WEEKS | ||||||||
| AuthorizedOfficialFirstName: | JAMES | ||||||||
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| AuthorizedOfficialTitleorPosition: | VICE PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 3052733024 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | PH. D | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 251C00000X | Y | Agencies | Day Training, Developmentally Disabled Services |
No ID Information.