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Organization
PROVIDENCE HEALTH CARE SERVICES
Active
Organization
PROVIDENCE HEALTH CARE SERVICES
Active
Other names
Sunrise Assisted Living
Organization subpart
No
Provider details
NPI number
Authorized official
JARED KENYANYA RN (CEO)
(612) 456-2773
Entity
Organization
Contact information
Practice address
781 103RD AVE NE, BLAINE, MN 55434-4507
(612) 456-2773
(763) 374-4469
Mailing address
781 103RD AVE NE, BLAINE, MN 55434-4507
(612) 456-2773
(763) 374-4469
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Enumeration date
04/17/2023
Last updated
05/30/2025
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