SUNRISE DETOX ORLANDO LLC – Mental Illness Community Based Residential Treatment Facility, NPI 1790140408

SUNRISE DETOX ORLANDO LLC is a healthcare provider. based in Lake worth, Florida. specializing in Mental Illness Community Based Residential Treatment Facility. The NPI Number for SUNRISE DETOX ORLANDO LLC is 1790140408

Main info

Organization
Name
SUNRISE DETOX ORLANDO LLC
NPI
1790140408
Phone
Not provided
Address
2328 10TH AVE N STE 302
Authorized Official
NICK MATTEO CFO
Enumeration Date
22 December 2015
Last Update Date
11 October 2023
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience40
Completeness75
Years active:10State licenses:0Digital endpointsOther names

Provider Addresses for SUNRISE DETOX ORLANDO LLC

  • 2328 10TH AVE N STE 302

    LAKE WORTH, FL 334616612

    Phone:

    Type: Mailing

  • 2431 SAND LAKE RD

    ORLANDO, FL 328097641

    Phone: (855) 876-8648

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2023-07-14

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
O20230714001238OOpioid Treatment Program (Otp)FLTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

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Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 33461)

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Reviews

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Frequently asked questions

How is SUNRISE DETOX ORLANDO LLC identified in CMS data?
CMS-hosted NPPES data lists SUNRISE DETOX ORLANDO LLC with NPI 1790140408.
Does the file indicate SUNRISE DETOX ORLANDO LLC is practicing under active NPI?
Directory data currently reports SUNRISE DETOX ORLANDO LLC as active.
What is SUNRISE DETOX ORLANDO LLC's primary classification?
Mental Illness Community Based Residential Treatment Facility is the headline specialty for SUNRISE DETOX ORLANDO LLC here. Clinical services aligned with this taxonomy classification.
What area does SUNRISE DETOX ORLANDO LLC serve?
SUNRISE DETOX ORLANDO LLC's listing highlights Lake Worth, Florida; more addresses can appear in NPPES.
What does 'Organization' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.

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