Sunrise II

Primary specialty

Intellectual Disabilities Intermediate Care FacilityTaxonomy code 315P00000X

License

0100372 Issued in CA

Legal business name

SUNRISE II

Practice address

48 Golden Hinde Blvd
San Rafael, CA 94903-3817

Phone

(415) 472-2373

Fax

(415) 472-5739

NPI assigned

May 19, 2008

Organization subpart

Yes

Parent organization

MARIN ASSOC FOR RETARDED CITIZENS (LIFEHOUSE)As reported in NPPES

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

Authorized official

Name

Merlyn Teague

Title

Director of Admin/Finacil

Phone

(415) 472-2373

Specialties & licenses 1

Addresses

Other identifiers 2

Tax ID family

Big R Respite Home5 organizations share this tax ID, including this one

Part of

Big R Respite Home

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

• Lifehouse Ine

  • Intellectual Disabilities Intermediate Care Facility
  • San Rafael, CA
  • NPI 1528240785
  NPD tax ID
• Nova Inc

  • Intellectual Disabilities Intermediate Care Facility
  • San Rafael, CA
  • NPI 1932366895
  NPD tax ID
• Stonehave

  • Intellectual Disabilities Intermediate Care Facility
  • Novato, CA
  • NPI 1770740623
  NPD tax ID
• Sunrise I

  • Intellectual Disabilities Intermediate Care Facility
  • Novato, CA
  • NPI 1891952719
  NPD tax ID

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

{
    "created_epoch": "1211155200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1211155200000",
    "number": "1528225455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 SMITH RANCH RD",
            "address_2": "SUITE 309",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949031900",
            "telephone_number": "415-472-2373",
            "fax_number": "415-472-5739"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "48 GOLDEN HINDE BLVD",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949033817",
            "telephone_number": "415-472-2373",
            "fax_number": "415-472-5739"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUNRISE II",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MARIN ASSOC FOR RETARDED CITIZENS (LIFEHOUSE)",
        "enumeration_date": "2008-05-19",
        "last_updated": "2008-05-19",
        "status": "A",
        "authorized_official_last_name": "TEAGUE",
        "authorized_official_first_name": "MERLYN",
        "authorized_official_title_or_position": "DIRECTOR OF ADMIN/FINACIL",
        "authorized_official_telephone_number": "415-472-2373"
    },
    "taxonomies": [
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": "CA",
            "license": "0100372",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "LTC60072F",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6205713",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Peter Vaughn Sullivan
• Stayce K Sullivan
• Summit Sober Living Inc.
• Sally Saemee Sun
• Lady Margie Sunico
• Renee Noemie Surcouf, LCSW
• Erica Sutherland, RN FNP
• Abro Sutker, N.D.
• Sutter Bay Medical Foundation
• Sutter West Bay Medical Foundation

• Intellectual Disabilities Intermediate Care Facility in San Rafael, CA
• Providers in San Rafael, CA by specialty
• Intellectual Disabilities Intermediate Care Facility in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2008; 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.