| Sunrise Outreach Solutions | |
|
7500 Dollarway Rd Ste 401 White Hall AR 71602-3083 | |
| (870) 466-4754 | |
| Not Available |
| Full Name | Sunrise Outreach Solutions |
|---|---|
| Speciality | Counselor |
| Location | 7500 Dollarway Rd Ste 401, White Hall, Arkansas |
| Authorized Official Name and Position | Nathan L Chennault (CEO) |
| Authorized Official Contact | 8704664754 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sunrise Outreach Solutions Po Box 622 Sheridan AR 72150-0622 Ph: (870) 466-4754 | Sunrise Outreach Solutions 7500 Dollarway Rd Ste 401 White Hall AR 71602-3083 Ph: (870) 466-4754 |
| NPI Number | 1376160945 |
|---|---|
| Provider Enumeration Date | 06/30/2020 |
| Last Update Date | 07/17/2020 |
| Certification Date | 07/17/2020 |
| Medicare PECOS PAC ID | 9638594674 |
|---|---|
| Medicare Enrollment ID | O20200807000086 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376160945 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Nathan Lee Chennault |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1629320122 PECOS PAC ID: 0547685588 Enrollment ID: I20200807000149 |
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