# SUN RIZE RESIDENCE

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1578394979
- **Authorized official:** TIESHQUANNA RICHARDSON (ADMIN)
- **Authorized official phone:** (919) 664-2155

## Contact information

- **Practice address:** 104 S SMITHFIELD RD, KNIGHTDALE, NC 27545-7781
- **Practice address phone:** (919) 664-2155
- **Mailing address:** PO BOX 94, CLAYTON, NC 27528-0094

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 311Z00000X | Custodial Care Facility | — | NULL | — |
| 311ZA0620X | Adult Care Home Facility | — | NULL | Yes |
| 320600000X | Intellectual and/or Developmental Disabilities Residential Treatment Facility | — | NULL | — |
| 343900000X | Non-emergency Medical Transport (VAN) | — | NULL | — |
| 347C00000X | Private Vehicle | — | NULL | — |

## Other

- **Enumeration date:** 08/08/2024
- **Last updated:** 08/08/2024