Provider Demographics
NPI:1962234237
Name:SUNRISE SERVICES ENTERPRISE
Entity type:Organization
Organization Name:SUNRISE SERVICES ENTERPRISE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:FRAN
Authorized Official - Middle Name:CLANEISE
Authorized Official - Last Name:HATCHER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:323-514-0121
Mailing Address - Street 1:2714 W FLORENCE AVE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90043-5151
Mailing Address - Country:US
Mailing Address - Phone:323-514-0121
Mailing Address - Fax:
Practice Address - Street 1:2714 W FLORENCE AVE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90043-5151
Practice Address - Country:US
Practice Address - Phone:323-514-0121
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-15
Last Update Date:2024-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)