Organization
SUNRISE AT PARWKAY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ELIZABETH MATOS (OWNER)
(706) 945-5582
Entity
Organization
Contact information
Practice address
1339 INTERSTATE PKWY, AUGUSTA, GA 30909-5626
(706) 868-8817
(706) 868-8878
Mailing address
1339 INTERSTATE PKWY, AUGUSTA, GA 30909-5626
(706) 868-8817
(706) 868-8878
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0003216623B
—
GA
Enumeration date
04/07/2022
Last updated
04/07/2022
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