Provider Demographics
NPI:1437045648
Name:SUNRISE GROWTH AND RENEWAL L.L.C.
Entity type:Organization
Organization Name:SUNRISE GROWTH AND RENEWAL L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:ALLEN
Authorized Official - Last Name:FOUTS
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:980-223-2838
Mailing Address - Street 1:224 TURNERSBURG HWY # 1040
Mailing Address - Street 2:
Mailing Address - City:STATESVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28625-2797
Mailing Address - Country:US
Mailing Address - Phone:980-223-2838
Mailing Address - Fax:
Practice Address - Street 1:601 E IREDELL AVE
Practice Address - Street 2:
Practice Address - City:MOORESVILLE
Practice Address - State:NC
Practice Address - Zip Code:28115-2425
Practice Address - Country:US
Practice Address - Phone:980-223-2838
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-06-16
Last Update Date:2025-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health