Sunrise Detox Millbury LLC

Primary specialty

Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X

Legal business name

SUNRISE DETOX MILLBURY LLC

Practice address

29 Main St
Millbury, MA 01527-2005

Phone

(508) 581-5225

Fax

(508) 865-2823

NPI assigned

Aug 30, 2018

Organization subpart

No

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

Authorized official

Name

Joseph M Chelales

Title

Administrator

Phone

(646) 285-4035

Specialties & licenses 2

Addresses

Other identifiers 1

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

{
    "created_epoch": "1535587200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1696982400000",
    "number": "1093297673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 12586",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071013562",
            "telephone_number": "508-581-5225",
            "fax_number": "508-865-2823"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29 MAIN ST",
            "city": "MILLBURY",
            "state": "MA",
            "postal_code": "015272005",
            "telephone_number": "508-581-5225",
            "fax_number": "508-865-2823"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUNRISE DETOX MILLBURY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-08-30",
        "last_updated": "2023-10-11",
        "certification_date": "2023-10-11",
        "status": "A",
        "authorized_official_last_name": "CHELALES",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "646-285-4035"
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TIN",
            "identifier": "XX-XXX9587",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ami Shah
• April Skaparas, MS CCC/SLP
• Rosalhiry Somersall
• William Clemens Spang, D.D.S.
• Anastasia St Cloud
• Sunrise Detox Millbury Ma, LLC
• Michael William Taylor, RT(R)(CV)(CI)
• The Counseling Center at Millbury Ma, LLC
• The Growth Collective, LLC
• Tide & Thrive Counseling LLC

• Mental Illness Community Based Residential Treatment Facility in Millbury, MA
• Providers in Millbury, MA by specialty
• Mental Illness Community Based Residential Treatment Facility in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2023; 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.