Provider Demographics
NPI:1538987078
Name:EAGLE SUNRISE, LLC
Entity type:Organization
Organization Name:EAGLE SUNRISE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:DUNN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:413-265-5498
Mailing Address - Street 1:20 TRI CITY PLAZA
Mailing Address - Street 2:UNIT 0001 #1011
Mailing Address - City:SOMERSWORTH
Mailing Address - State:NH
Mailing Address - Zip Code:03878
Mailing Address - Country:US
Mailing Address - Phone:413-265-5498
Mailing Address - Fax:
Practice Address - Street 1:74 HEDDING RD
Practice Address - Street 2:
Practice Address - City:EPPING
Practice Address - State:NH
Practice Address - Zip Code:03042-2526
Practice Address - Country:US
Practice Address - Phone:413-265-5498
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-02
Last Update Date:2024-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty