| Sunrise Children's Services, Inc. | |
|
190 Madison Square Dr Ste B Madisonville KY 42431-2785 | |
| (270) 874-2560 | |
| Not Available |
| Full Name | Sunrise Children's Services, Inc. |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 190 Madison Square Dr Ste B, Madisonville, Kentucky |
| Authorized Official Name and Position | Sharon C' De Baca (EXECUTIVE ASSISTANT TO PRESIDENT) |
| Authorized Official Contact | 5025381010 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Sunrise Children's Services, Inc. Po Box 1429 Mt Washington KY 40047-1429 Ph: (502) 538-1000 | Sunrise Children's Services, Inc. 190 Madison Square Dr Ste B Madisonville KY 42431-2785 Ph: (270) 874-2560 |
| NPI Number | 1497097562 |
|---|---|
| Provider Enumeration Date | 03/26/2013 |
| Last Update Date | 10/25/2022 |
| Certification Date | 10/25/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497097562 | NPI | - | NPPES |
| 7100326270 | Medicaid | KY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 1395 (Kentucky) | Primary |
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