Provider Demographics
NPI:1285070078
Name:SUN HEALTH SERVICES
Entity type:Organization
Organization Name:SUN HEALTH SERVICES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE VICE PRESIDENT/CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:LA RUE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:623-471-9551
Mailing Address - Street 1:14719 W GRAND AVE
Mailing Address - Street 2:
Mailing Address - City:SURPRISE
Mailing Address - State:AZ
Mailing Address - Zip Code:85374-7203
Mailing Address - Country:US
Mailing Address - Phone:623-471-9355
Mailing Address - Fax:623-213-8523
Practice Address - Street 1:14719 W GRAND AVE
Practice Address - Street 2:
Practice Address - City:SURPRISE
Practice Address - State:AZ
Practice Address - Zip Code:85374-7203
Practice Address - Country:US
Practice Address - Phone:623-832-5563
Practice Address - Fax:623-832-4101
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-20
Last Update Date:2020-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No251B00000XAgenciesCase Management
No261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health
No261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty