Organization
SUNRISE YOUTH SERVICES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MASON ANDREW PETERSON (CHIEF EXECUTIVE OFFICER)
(701) 639-3356
Entity
Organization
Contact information
Practice address
112 UNIVERSITY DR N STE L140, FARGO, ND 58102-4635
(701) 639-3356
Mailing address
112 UNIVERSITY DR N STE L140, FARGO, ND 58102-4635
(701) 639-3356
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
—
Other
Enumeration date
08/03/2024
Last updated
08/03/2024
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