| Sunrise Treatment Center, Llc | |
| 
					247 Cic Blvd West Union OH 45693  | |
| (513) 941-4999 | |
| Not Available | 
| Full Name | Sunrise Treatment Center, Llc | 
|---|---|
| Speciality | Clinic/center - Rehabilitation, Substance Use Disorder | 
| Location | 247 Cic Blvd, West Union, Ohio | 
| Authorized Official Name and Position | Randy Spaulding (CREDENTIALING) | 
| Authorized Official Contact | 5134672825 | 
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. | 
| Mailing Address | Practice Location Address | 
|---|---|
| Sunrise Treatment Center, Llc 6460 Harrison Ave Ste 200 Cincinnati OH 45247-7958 Ph: (513) 941-4999  | Sunrise Treatment Center, Llc 247 Cic Blvd West Union OH 45693 Ph: (513) 941-4999  | 
| NPI Number | 1215659412 | 
|---|---|
| Provider Enumeration Date | 09/14/2022 | 
| Last Update Date | 12/28/2022 | 
| Certification Date | 12/28/2022 | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1215659412 | NPI | - | NPPES | 
| 0313320 | Medicaid | OH | |
| 0078786 | Medicaid | OH | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Secondary | 
| 261QR0405X | Clinic/center - Rehabilitation, Substance Use Disorder | (* (Not Available)) | Primary | 
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