Organization
SISU LIVING LLC
Active
Other names
Sisu Living LLC
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SUMMER A KLENKEN (BUSINESS MANAGER & OWNER)
(320) 292-0366
Entity
Organization
Contact information
Practice address
2107 TROOP DR STE 201, SARTELL, MN 56377-4563
(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
—
—
251S00000X
Community/Behavioral Health Agency
—
—
253Z00000X
In Home Supportive Care Agency
Primary
—
—
311Z00000X
Custodial Care Facility
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1710764105
ICS TRIPLEX
MN
Enumeration date
02/23/2022
Last updated
03/25/2024
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