Organization
SUNRISE AT SOUTH MOUNTAIN LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ASHANTE WASHINGTON (CO-OWNER, ADMINISTRATOR)
(510) 640-2780
Entity
Organization
Contact information
Practice address
403 E MILADA DR, PHOENIX, AZ 85042-7676
(602) 633-5573
Mailing address
403 E MILADA DR, PHOENIX, AZ 85042-7676
(602) 633-5573
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
324500000X
Substance Abuse Rehabilitation Facility
—
—
Other
Enumeration date
08/09/2021
Last updated
08/09/2021
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