SUNRISE DETOX MILLBURY LLC NPI 1093297673

NPI Information

NPI: 1093297673
Provider Name: SUNRISE DETOX MILLBURY LLC
Classification: Substance Abuse Rehabilitation Facility - 324500000X
Entity Type: Organization

CLIA Number: 22D2154738

Address:
29 MAIN ST
MILLBURY, MA
ZIP 01527
Phone: (508) 581-5225
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SUNRISE DETOX MILLBURY LLC is a substance abuse rehabilitation facility in Millbury, MA. The provider is a facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances. SUNRISE DETOX MILLBURY LLC NPI is 1093297673. The provider is registered as an organization entity type.

The provider's business location address is:

29 MAIN ST
MILLBURY, MA
ZIP 01527-005
Phone: (508) 581-5225
Fax: (508) 865-2823

The provider's authorized official is Joseph M Chelales .
The authorized official title is Administrator and has the following contact phone number (646) 285-4035.

The CLIA number assigned to this NPI record is 22D2154738 - independent with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 8/30/2018 and was last updated on 11/15/2018.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	324500000X	Substance Abuse Rehabilitation Facility				Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	XX-XXX9587	OTHER	MASSACHUSETTS	TIN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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