Sun Ray Holding Company, LLC

Primary specialty

Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X

Legal business name

SUN RAY HOLDING COMPANY, LLC

Practice address

31641 Auto Center Dr
Room 1
Lake Elsinore, CA 92530-4535

Phone

(772) 247-1782

Fax

(772) 210-2758

NPI assigned

Mar 17, 2016

Organization subpart

Yes

Parent organization

SUN RAY COAST TREATMENT CENTER LLCAs reported in NPPES

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

Authorized official

Name

Mr. Edward Rousseau

Title

Chief Administrative Officer

Phone

(772) 266-7682

Specialties & licenses 1

Addresses

Other names 1

• Sun Ray Addictions Counseling & Education Doing business as

Locations

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

{
    "created_epoch": "1458172800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1539043200000",
    "number": "1508227562",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 101774",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911891774",
            "telephone_number": "772-247-1428",
            "fax_number": "772-210-5697"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31641 AUTO CENTER DR",
            "address_2": "ROOM 1",
            "city": "LAKE ELSINORE",
            "state": "CA",
            "postal_code": "925304535",
            "telephone_number": "772-247-1782",
            "fax_number": "772-210-2758"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUN RAY HOLDING COMPANY, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SUN RAY COAST TREATMENT CENTER LLC",
        "enumeration_date": "2016-03-17",
        "last_updated": "2018-10-09",
        "status": "A",
        "authorized_official_last_name": "ROUSSEAU",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_title_or_position": "CHIEF ADMINISTRATIVE OFFICER",
        "authorized_official_telephone_number": "772-266-7682",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sun Ray Addictions Counseling & Education",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Sun Ray Addictions Counseling & Education",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Emily Lynn Storey
• April Stotler, OTR/L
• Corrie Strain, C.A.S.
• Kelsey Christine Studebaker, CNMT
• Alexandria June Suitor, RN
• Douglas Ray Surface, BS
• Vickie Sutton
• Allison Bird Svidergol
• Synergy Hills LLC
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• Multi-Specialty Clinic/Center in Lake Elsinore, CA
• Providers in Lake Elsinore, CA by specialty
• Multi-Specialty Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2018; 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.