Organization
SUNRISE DETOX III, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JASON USILTON (DIRECTOR)
(561) 318-4400
Entity
Organization
Contact information
Practice address
2331 NE 53RD ST, FORT LAUDERDALE, FL 33308-3235
(954) 491-9700
(561) 228-0836
Mailing address
2328 10TH AVE N, #301, LAKE WORTH, FL 33461-6606
(561) 318-4414
(561) 533-3832
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
—
324500000X
Substance Abuse Rehabilitation Facility
1706AD576201
FL
Other
Enumeration date
08/29/2012
Last updated
10/11/2023
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