SUNRISE CLINICAL SERVICES LLC NPI 1336404417

NPI Information

  • NPI: 1336404417
  • Provider Name: SUNRISE CLINICAL SERVICES, LLC
  • Classification: Clinic/Center - 261QM2800X
  • Specialization: Methadone
  • Entity Type: Organization
  • Former Legal Business Name: OASIS CLINICAL
  • CLIA Number: 31D2095829
  • Address: 22 BALL ST
    IRVINGTON, NJ
    ZIP 07111
  • Phone: (739) 372-1095

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NPI Details

SUNRISE CLINICAL SERVICES, LLC is a methadone clinic center in Irvington, NJ. The provider is an entity, facility, or distinct part of a facility providing diagnostic, and replacement maintenance treatment services related to individuals with drug addiction. SUNRISE CLINICAL SERVICES, LLC NPI is 1336404417. The provider is registered as an organization entity type.
The provider Former Legal Business Name Is Oasis Clinical.

The provider's business location address is:

22 BALL ST
IRVINGTON, NJ
ZIP 07111-521
Phone: (739) 372-1095
Fax: (973) 372-1096

The provider's authorized official is Terryann Maree Dechert .
The authorized official title is Admin and has the following contact phone number (201) 600-1812.

The CLIA number assigned to this NPI record is 31D2095829 - comp. outpatient rehab facility with a certificate type of Certificate of Waiver.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Medication assisted treatment, methadone; weekly bundle including dispensing and/or administration, substance use counseling, individual and group therapy, and toxicology testing, if performed (provision of the services by a medicare-enrolled opioid treatm (HCPCS:G2067)

The enumeration date for this NPI number is 7/5/2012 and was last updated on 8/13/2024.

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
1261QM2800XClinic/CenterMethadoneYes

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
10370703MEDICAIDNEW JERSEY

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: 11/21/2025

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