Sunrise Lifecare369 LLC

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

SUNRISE LIFECARE369 LLC

Practice address

414 Madina Cir
Davenport, FL 33837-8854

Phone

(720) 549-1851

NPI assigned

Sep 9, 2025

Organization subpart

No

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

Authorized official

Name

Mrs. Shateta L Clark

Title

Ceo

Phone

(720) 549-1851

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1757376000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757376000000",
    "number": "1518848423",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "414 MADINA CIR",
            "city": "DAVENPORT",
            "state": "FL",
            "postal_code": "338378854",
            "telephone_number": "720-549-1851"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "414 MADINA CIR",
            "city": "DAVENPORT",
            "state": "FL",
            "postal_code": "338378854",
            "telephone_number": "720-549-1851"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUNRISE LIFECARE369 LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-09-09",
        "last_updated": "2025-09-09",
        "certification_date": "2025-09-08",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "SHATETA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "720-549-1851",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2025; 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.