Basic Information
| Provider Information | |||||||||
| NPI: | 1942870324 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | SUNRISE COMMUNITY, INC. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 9040 SUNSET DR | ||||||||
| Address2: | |||||||||
| City: | MIAMI | ||||||||
| State: | FL | ||||||||
| PostalCode: | 331733432 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3055969040 | ||||||||
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| Practice Location | |||||||||
| Address1: | 3021 SOUTHSHORE CIR | ||||||||
| Address2: | |||||||||
| City: | TALLAHASSEE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 323121822 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3055969040 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/29/2021 | ||||||||
| LastUpdateDate: | 06/29/2021 | ||||||||
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| AuthorizedOfficialLastName: | GARCIA | ||||||||
| AuthorizedOfficialFirstName: | ANA | ||||||||
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| AuthorizedOfficialTitleorPosition: | DIRECTOR OF REVENUE CYCLE | ||||||||
| AuthorizedOfficialTelephone: | 3052733047 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MRS. | ||||||||
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| NPICertificationDate: | 06/08/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 310500000X | Y | Nursing & Custodial Care Facilities | Intermediate Care Facility, Mental Illness |
No ID Information.