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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