Provider Demographics
NPI:1386067296
Name:SUNRISE CMHC, INC
Entity type:Organization
Organization Name:SUNRISE CMHC, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DAMIAN
Authorized Official - Middle Name:OKPAKO
Authorized Official - Last Name:IDJAGBORO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-366-5980
Mailing Address - Street 1:19607 NORFOLK RIDGE WAY
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77407-7123
Mailing Address - Country:US
Mailing Address - Phone:832-366-5980
Mailing Address - Fax:
Practice Address - Street 1:19607 NORFOLK RIDGE WAY
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:TX
Practice Address - Zip Code:77407-7123
Practice Address - Country:US
Practice Address - Phone:832-366-5980
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-28
Last Update Date:2014-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty