Organization Name: | SUNRISE LIFESTYLE CENTERS LLC |
NPI Number: | 1023075561 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JEFF T GRADE (CEO) |
Mailing Address: | 658 Kenilworth Dr Suite 100 Towson |
State: | MD US |
Postal Code: | 212042312 |
Phone Number: | 4102964901 |
Fax Number: | 4102964971 |
NPI Enumeration Date: | 04/27/2006 |
NPI Last Update Date: | 09/12/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QR0400X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Rehabilitation |
Taxonomy Definition: |