| Sunrise Psychiatry Llc | |
|
721 Long Point Rd Ste 408b Mt Pleasant SC 29464-8298 | |
| (843) 810-8591 | |
| Not Available |
| Full Name | Sunrise Psychiatry Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 721 Long Point Rd Ste 408b, Mt Pleasant, South Carolina |
| Authorized Official Name and Position | Khoa Vo (OWNER) |
| Authorized Official Contact | 8438108591 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sunrise Psychiatry Llc 721 Long Point Rd Ste 408b Mt Pleasant SC 29464-8298 Ph: () - | Sunrise Psychiatry Llc 721 Long Point Rd Ste 408b Mt Pleasant SC 29464-8298 Ph: (843) 810-8591 |
| NPI Number | 1497234223 |
|---|---|
| Provider Enumeration Date | 08/13/2018 |
| Last Update Date | 07/03/2020 |
| Certification Date | 07/03/2020 |
| Medicare PECOS PAC ID | 4789922154 |
|---|---|
| Medicare Enrollment ID | O20190208002726 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497234223 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Khoa Vo |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1225094931 PECOS PAC ID: 2567494016 Enrollment ID: I20100622000145 |
| Provider Name | Elizabeth Ann Holloway Jensen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548230220 PECOS PAC ID: 8820421753 Enrollment ID: I20191209000422 |
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