| Entity Name: | SUNRISE COMMUNITY OF POLK COUNTY, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Non-Profit |
| Status: | Active |
| Date Filed: | 02 Dec 1996 (28 years ago) |
| Document Number: | N96000006187 |
| FEI/EIN Number | 650714062 |
| Address: | 9040 SUNSET DRIVE, SUITE A, MIAMI, FL, 33173 |
| Mail Address: | 9040 SUNSET DRIVE, SUITE A, MIAMI, FL, 33173 |
| ZIP code: | 33173 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1851433270 | 2007-02-13 | 2020-08-22 | 807 N LAKE PARKER AVE, LAKELAND, FL, 338012044, US | 807 N LAKE PARKER AVE, LAKELAND, FL, 338012044, US | |||||||||||||
|
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| Phone | +1 863-680-2817 |
Authorized person
| Name | DR. JAMES WEEKS |
| Role | BOARD SECRETARY |
| Phone | 3052733024 |
Taxonomy
| Taxonomy Code | 320900000X - Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| Wray Zachary | Agent | 9040 SUNSET DRIVE, MIAMI, FL, 33173 |
| Name | Role | Address |
|---|---|---|
| PUJOL ROSE B | Director | 1755 FAIRHAVEN PLACE, MIAMI, FL, 33133 |
| CROWTHER CONNIE | Director | 2506 PONCE DELEON BLVD #101, CORAL GABLES, FL, 33134 |
| Coker Robert | Director | 9040 SUNSET DRIVE, MIAMI, FL, 33173 |
| Name | Role | Address |
|---|---|---|
| Wray Zachary | President | 9040 SUNSET DRIVE, MIAMI, FL, 33173 |
| Name | Role | Address |
|---|---|---|
| Potter Sherri L | Asst | 9040 SUNSET DRIVE, MIAMI, FL, 33173 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G10000077776 | SUNRISE COMMUNITY OF CENTRAL FLORIDA | ACTIVE | 2010-08-24 | 2025-12-31 | No data | 9040 SUNSET DRIVE, ATTN: SHERRI POTTER, MIAMI, FL, 33173 |
Date of last update: 02 Jan 2025
Sources: Florida Department of State
