Provider Demographics
NPI:1982567160
Name:SUN STREET CENTERS
Entity type:Organization
Organization Name:SUN STREET CENTERS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL SUPERVISOR II
Authorized Official - Prefix:
Authorized Official - First Name:GORDON
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:HORNE
Authorized Official - Suffix:
Authorized Official - Credentials:LAADC #LCI0170115
Authorized Official - Phone:808-295-8982
Mailing Address - Street 1:245 WASHINGTON ST STE A&B
Mailing Address - Street 2:
Mailing Address - City:MONTEREY
Mailing Address - State:CA
Mailing Address - Zip Code:93940-2409
Mailing Address - Country:US
Mailing Address - Phone:831-753-6001
Mailing Address - Fax:831-759-2269
Practice Address - Street 1:245 WASHINGTON ST STE A&B
Practice Address - Street 2:
Practice Address - City:MONTEREY
Practice Address - State:CA
Practice Address - Zip Code:93940-2409
Practice Address - Country:US
Practice Address - Phone:831-753-6001
Practice Address - Fax:831-759-2269
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SUN STREET CENTERS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-12-04
Last Update Date:2025-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty