# SUNFLAKE

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1598165359
- **Authorized official:** JACOB DEVNEY (OWNER)
- **Authorized official phone:** (612) 730-7955

## Contact information

- **Practice address:** 6525 CENTRAL AVE NE UNIT 2, FRIDLEY, MN 55432-4653
- **Practice address phone:** (612) 730-7955
- **Mailing address:** 6525 CENTRAL AVE NE UNIT 2, FRIDLEY, MN 55432-4653

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 320700000X | Physical Disabilities Residential Treatment Facility | EA657799 | MN | Yes |

## Other

- **Enumeration date:** 08/29/2014
- **Last updated:** 08/29/2014