Organization
SUNSHINE GROUP HOME LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FEISAL MOHAMED (OWNER)
(612) 229-8207
Entity
Organization
Contact information
Practice address
125 MAGNOLIA AVE W, SAINT PAUL, MN 55117-4916
(612) 227-5643
Mailing address
125 MAGNOLIA AVE W, SAINT PAUL, MN 55117-4916
(612) 227-5643
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
—
—
310400000X
Assisted Living Facility
Primary
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
343900000X
Non-emergency Medical Transport (VAN)
—
—
Other
Enumeration date
08/28/2020
Last updated
01/31/2023
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