Provider Demographics
NPI:1619733367
Name:SUNRISE BEHAVIORAL CENTER INC
Entity type:Organization
Organization Name:SUNRISE BEHAVIORAL CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-FOUNDER
Authorized Official - Prefix:MS
Authorized Official - First Name:MACKY
Authorized Official - Middle Name:
Authorized Official - Last Name:NAIJUKA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:562-471-8968
Mailing Address - Street 1:111 W HARRISON ST
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98119-4286
Mailing Address - Country:US
Mailing Address - Phone:562-471-8968
Mailing Address - Fax:
Practice Address - Street 1:111 W HARRISON ST
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98119-4286
Practice Address - Country:US
Practice Address - Phone:562-471-8968
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-21
Last Update Date:2024-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty