Mikouis Enterprises, Inc., Dba Sunrise Homes

Primary specialty

Intellectual Disabilities Intermediate Care FacilityTaxonomy code 315P00000X

License

24817 Issued in OH

Legal business name

MIKOUIS ENTERPRISES, INC., DBA SUNRISE HOMES

Practice address

38655 Saltwell Rd
Lisbon, OH 44432-8348

Phone

(330) 424-1418

Fax

(330) 424-1920

NPI assigned

Jan 5, 2008

Last updated

Jan 5, 2008By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Jeannette Mikouis, LNHA, RD/LD, RN

Title

Administrator

Phone

(330) 424-1418

Specialties & licenses 1

Addresses

Other identifiers 1

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1199491200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1199491200000",
    "number": "1003091323",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "38655 SALTWELL RD",
            "address_2": "P.O. BOX 329",
            "city": "LISBON",
            "state": "OH",
            "postal_code": "444328348",
            "telephone_number": "330-424-1418",
            "fax_number": "330-424-1920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "38655 SALTWELL RD",
            "city": "LISBON",
            "state": "OH",
            "postal_code": "444328348",
            "telephone_number": "330-424-1418",
            "fax_number": "330-424-1920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIKOUIS ENTERPRISES, INC., DBA SUNRISE HOMES",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-05",
        "last_updated": "2008-01-05",
        "status": "A",
        "authorized_official_last_name": "MIKOUIS",
        "authorized_official_first_name": "JEANNETTE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "330-424-1418",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LNHA, RD/LD, RN"
    },
    "taxonomies": [
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": "OH",
            "license": "24817",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0115048",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Richard McMonagle, LPCC
• Molly M McQuillan
• Melissa Mellon, COTA/L
• Richard Alan Mercer, RN
• Renee Meyer, LPC
• Mikouis Home Delivery Healthcare, LLC
• Miller Holdings Sunrise, Inc. (Sunrise Homes)
• Mary Ellen Miller, LPN
• Nicole Miller
• Carla Sue Moats

• Intellectual Disabilities Intermediate Care Facility in Lisbon, OH
• Providers in Lisbon, OH by specialty
• Intellectual Disabilities Intermediate Care Facility in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.