| Sunrise Treatment Center - Portsmouth | |
|
1907 11th St Portsmouth OH 45662-4531 | |
| (513) 941-4999 | |
| Not Available |
| Full Name | Sunrise Treatment Center - Portsmouth |
|---|---|
| Speciality | Clinic/center - Rehabilitation, Substance Use Disorder |
| Location | 1907 11th St, Portsmouth, Ohio |
| Authorized Official Name and Position | Randy Henry. Spaulding (C.O.O.) |
| Authorized Official Contact | 5134672825 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Sunrise Treatment Center - Portsmouth 6460 Harrison Ave Ste 200 Cincinnati OH 45247-7958 Ph: (513) 467-2825 | Sunrise Treatment Center - Portsmouth 1907 11th St Portsmouth OH 45662-4531 Ph: (513) 941-4999 |
| NPI Number | 1407502883 |
|---|---|
| Provider Enumeration Date | 02/24/2022 |
| Last Update Date | 06/03/2024 |
| Certification Date | 06/03/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407502883 | NPI | - | NPPES |
| 0313320 | Medicaid | OH | |
| 0078786 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Secondary |
| 261QR0405X | Clinic/center - Rehabilitation, Substance Use Disorder | (* (Not Available)) | Primary |
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