Organization
SUN RAY HOLDING COMPANY, LLC
Active
Parent organization
SUN RAY COAST TREATMENT CENTER LLC
Other names
Sun Ray Addictions Counseling & Education
Organization subpart
Yes
Provider details
NPI number
Legal business name
SUN RAY COAST TREATMENT CENTER LLC
Authorized official
MR. EDWARD ROUSSEAU (CHIEF ADMINISTRATIVE OFFICER)
(772) 266-7682
Entity
Organization
Contact information
Practice address
31641 AUTO CENTER DR, ROOM 1, LAKE ELSINORE, CA 92530-4535
(772) 247-1782
(772) 210-2758
Mailing address
PO BOX 101774, PASADENA, CA 91189-1774
(772) 247-1428
(772) 210-5697
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Enumeration date
03/17/2016
Last updated
10/09/2018
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