Sunrise Behavioral Health Services Llc | |
39 Country Club Ln Brockton MA 02301-7098 | |
(508) 308-3736 | |
Not Available |
Full Name | Sunrise Behavioral Health Services Llc |
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Speciality | Community/Behavioral Health |
Location | 39 Country Club Ln, Brockton, Massachusetts |
Authorized Official Name and Position | Clare E Katuramu (CHIEF EXECUTIVE OFFICER) |
Authorized Official Contact | 5083083736 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Sunrise Behavioral Health Services Llc 39 Country Club Ln Brockton MA 02301-7098 Ph: (508) 308-3736 | Sunrise Behavioral Health Services Llc 39 Country Club Ln Brockton MA 02301-7098 Ph: (508) 308-3736 |
NPI Number | 1073000121 |
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Provider Enumeration Date | 04/15/2018 |
Last Update Date | 04/15/2018 |
Medicare PECOS PAC ID | 9537403274 |
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Medicare Enrollment ID | O20181206000396 |
Identifier | Type | State | Issuer |
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1073000121 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
Provider Name | Clare E Katuramu |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1245559780 PECOS PAC ID: 9436387438 Enrollment ID: I20140121001944 |
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