Organization
SUNRISE DETOX ORLANDO LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NICK MATTEO (CFO)
(561) 318-4430
Entity
Organization
Contact information
Practice address
2431 SAND LAKE RD, ORLANDO, FL 32809-7641
(855) 876-8648
Mailing address
2328 10TH AVE N STE 302, LAKE WORTH, FL 33461-6612
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
—
324500000X
Substance Abuse Rehabilitation Facility
—
—
Other
Enumeration date
12/22/2015
Last updated
10/11/2023
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