Organization
SUNRISE RESIDENTIAL SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TUFAH HASSAN MOALLIN (OWNER/MANAGER)
(206) 458-3553
Entity
Organization
Contact information
Practice address
216 MAPLE LN, ROSEVILLE, MN 55113
(206) 458-3553
Mailing address
216 MAPLE LN, ROSEVILLE, MN 55113
(206) 458-3553
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
—
—
251J00000X
Nursing Care Agency
385493
MN
253Z00000X
In Home Supportive Care Agency
1091521
MN
310400000X
Assisted Living Facility
Primary
—
—
332U00000X
Home Delivered Meals
1091521
MN
Other
Enumeration date
03/02/2018
Last updated
08/16/2019
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