Provider Demographics
NPI:1528247095
Name:SUNRISE POINT
Entity type:Organization
Organization Name:SUNRISE POINT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:JACQUELINE
Authorized Official - Middle Name:
Authorized Official - Last Name:SELLARS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-689-5288
Mailing Address - Street 1:842 NEW JERSEY AVE
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:27217-8891
Mailing Address - Country:US
Mailing Address - Phone:336-689-5288
Mailing Address - Fax:336-226-8088
Practice Address - Street 1:631 SPENCE ST
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:NC
Practice Address - Zip Code:27217-1271
Practice Address - Country:US
Practice Address - Phone:336-226-8004
Practice Address - Fax:336-226-8088
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-31
Last Update Date:2007-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCMHL001152320800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness