Organization
SISU LIVING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUMMER A KLENKEN (OWNER & BUSINESS MANAGER)
(320) 292-0366
Entity
Organization
Contact information
Practice address
125 2ND AVE NE, SAINT CLOUD, MN 56304-4000
(320) 292-0366
Mailing address
2107 TROOP DR STE 201, SARTELL, MN 56377-4563
(320) 292-0366
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
251S00000X
Community/Behavioral Health Agency
—
—
253Z00000X
In Home Supportive Care Agency
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1730835133
IN HOME SUPPORTS
MN
Enumeration date
09/11/2023
Last updated
03/25/2024
Update your record
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