Provider Demographics
NPI:1962080465
Name:SUNRISE CHILDREN'S SERVICES, INC.
Entity type:Organization
Organization Name:SUNRISE CHILDREN'S SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPERATIONS ANALYST
Authorized Official - Prefix:
Authorized Official - First Name:DANIELLE
Authorized Official - Middle Name:N
Authorized Official - Last Name:MERTZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:502-538-1000
Mailing Address - Street 1:300 HOPE ST
Mailing Address - Street 2:
Mailing Address - City:MT WASHINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40047-7757
Mailing Address - Country:US
Mailing Address - Phone:502-538-1000
Mailing Address - Fax:502-538-1100
Practice Address - Street 1:491 NEW START RD
Practice Address - Street 2:
Practice Address - City:BRONSTON
Practice Address - State:KY
Practice Address - Zip Code:42518-8572
Practice Address - Country:US
Practice Address - Phone:606-561-5797
Practice Address - Fax:606-561-9928
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-29
Last Update Date:2021-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty