Organization
SUN-RISE LIVING BEHAVIOR HEALTH SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MIGUEL MORENO-COLON (CEO)
(904) 745-0067
Entity
Organization
Contact information
Practice address
1257 EDGEWOOD AVE W, JACKSONVILLE, FL 32208-2741
(904) 745-0067
(904) 586-2550
Mailing address
1257 EDGEWOOD AVE W, JACKSONVILLE, FL 32208-2741
(904) 745-0067
(904) 586-2550
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
103TB0200X
Cognitive & Behavioral Psychologist
Primary
—
—
106H00000X
Marriage & Family Therapist
—
—
Other
Enumeration date
11/20/2014
Last updated
01/06/2025
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