Organization Active NPI

Sunrise Adult Care Inc

  • Assisted Living Facility
  • Lake Worth, FL
National Provider Identifier
1205242989
Registry record updated Jan 5, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
License
AL8286 Issued in FL
Legal business name
SUNRISE ADULT CARE INC
Practice address
4102 Cooley CT
Lake Worth, FL 33461-4312
Phone
(561) 967-2287
Fax
(561) 249-1394
NPI assigned
Jul 2, 2014
Last updated
Jan 5, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2015

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

Authorized official

Name
Mr. James E Hannah II
Title
Administrator/Owner
Phone
(561) 723-0671

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X AL8286 FL Primary

Addresses

Primary practice location

4102 Cooley CT
Lake Worth, FL 33461-4312

Mailing address

4102 Cooley CT
Lake Worth, FL 33461-4312
Phone (561) 967-2287

Other identifiers 1

IdentifierTypeStateIssuer
012434900MedicaidFL

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1404259200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1420416000000",
    "number": "1205242989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4102 COOLEY CT",
            "city": "LAKE WORTH",
            "state": "FL",
            "postal_code": "334614312",
            "telephone_number": "561-967-2287",
            "fax_number": "561-249-1394"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4102 COOLEY CT",
            "city": "LAKE WORTH",
            "state": "FL",
            "postal_code": "334614312",
            "telephone_number": "561-967-2287",
            "fax_number": "561-249-1394"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUNRISE ADULT CARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-07-02",
        "last_updated": "2015-01-05",
        "status": "A",
        "authorized_official_last_name": "HANNAH",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "ADMINISTRATOR/OWNER",
        "authorized_official_telephone_number": "561-723-0671",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "II"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "FL",
            "license": "AL8286",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "012434900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Worth, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2015; 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.