Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Respite Care |
385H00000X | |||
Prevention Professional |
405300000X |
| NPI # | 1073089256 |
||||
| LBN Legal business name | SUN STREET CENTERS | ||||
| Authorized official | GORDON HORNE - (CLINICAL SUPERVISOR) | ||||
| Entity | Organization | ||||
| Organization subpart 1 | No | ||||
| Enumeration date | 10/16/2018 | ||||
| Last updated | 10/16/2018 - About 8 years ago | ||||
| Identifiers |
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