Organization
SUN RIZE RESIDENCE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TIESHQUANNA RICHARDSON (ADMIN)
(919) 664-2155
Entity
Organization
Contact information
Practice address
104 S SMITHFIELD RD, KNIGHTDALE, NC 27545-7781
(919) 664-2155
Mailing address
PO BOX 94, CLAYTON, NC 27528-0094
Taxonomy
Speciality
Code
Description
License number
State
311Z00000X
Custodial Care Facility
—
—
311ZA0620X
Adult Care Home Facility
Primary
—
—
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
—
—
343900000X
Non-emergency Medical Transport (VAN)
—
—
347C00000X
Private Vehicle
—
—
Other
Enumeration date
08/08/2024
Last updated
08/08/2024
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