Organization Active NPI

Sunrise Behavioral Health Services LLC

  • Community/Behavioral Health Agency
  • Brockton, MA
National Provider Identifier
1073000121
Registry record updated Apr 15, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
SUNRISE BEHAVIORAL HEALTH SERVICES LLC
Practice address
39 Country Club LN
Brockton, MA 02301-7098
Phone
(508) 308-3736
NPI assigned
Apr 15, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2018

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

Authorized official

Name
Clare E Katuramu, DNPNPI 1245559780
Title
Chief Executive Officer
Phone
(508) 308-3736

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

39 Country Club LN
Brockton, MA 02301-7098

Mailing address

39 Country Club LN
Brockton, MA 02301-7098
Phone (508) 308-3736

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20181206000396 MA Part B Supplier - Clinic/Group Practice 9537403274 Receives reassigned benefits from 1 practitioner
Practice locations: West Bridgewater, MA

National Provider Directory

National Provider Directory

Locations

353 W Center St
#106
West Bridgewater, MA 02379
Phone (508) 857-0765

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1523750400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1523750400000",
    "number": "1073000121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39 COUNTRY CLUB LN",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023017098",
            "telephone_number": "508-308-3736"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39 COUNTRY CLUB LN",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023017098",
            "telephone_number": "508-308-3736"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUNRISE BEHAVIORAL HEALTH SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-04-15",
        "last_updated": "2018-04-15",
        "status": "A",
        "authorized_official_last_name": "KATURAMU",
        "authorized_official_first_name": "CLARE",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "508-308-3736",
        "authorized_official_credential": "DNP"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brockton, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.