Provider Demographics
NPI:1194509596
Name:SUNRISE OUTREACH CENTER OF YAKIMA
Entity type:Organization
Organization Name:SUNRISE OUTREACH CENTER OF YAKIMA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CASE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:NIKKI
Authorized Official - Middle Name:
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:509-910-9434
Mailing Address - Street 1:PO BOX 10413
Mailing Address - Street 2:
Mailing Address - City:YAKIMA
Mailing Address - State:WA
Mailing Address - Zip Code:98909-1413
Mailing Address - Country:US
Mailing Address - Phone:509-225-9310
Mailing Address - Fax:509-895-7775
Practice Address - Street 1:221 E MARTIN LUTHER KING JR BLVD
Practice Address - Street 2:
Practice Address - City:YAKIMA
Practice Address - State:WA
Practice Address - Zip Code:98901-2344
Practice Address - Country:US
Practice Address - Phone:509-225-9310
Practice Address - Fax:509-895-7775
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-24
Last Update Date:2023-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management