Organization
SUNSHINE SUPPORTIVE SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ELIJAH GEORGE NYAMBANE (DIRECTO)
(612) 590-0154
Entity
Organization
Contact information
Practice address
3207 67TH AVE N, BROOKLYN CENTER, MN 55429-1823
(612) 590-0154
Mailing address
17119 72ND AVE N, MAPLE GROVE, MN 55311-4565
(612) 590-0154
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
343900000X
Non-emergency Medical Transport (VAN)
—
—
Other
Enumeration date
09/24/2025
Last updated
09/24/2025
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