Active NPI
Sunshine Supportive Services
- Respite Care
- Brooklyn Center, MN
National Provider Identifier
1003702929
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Respite Care
- Legal business name
- SUNSHINE SUPPORTIVE SERVICES
- Practice address
- 3207 67TH Ave N
Brooklyn Center, MN 55429-1823 - Phone
- (612) 590-0154
- NPI assigned
- Jun 16, 2025
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Elijah George Nyambane
- Title
- Owner/Ceo
- Phone
- (612) 590-0154
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Agency | 251E00000X | |||
| Nursing Care Agency | 251J00000X | |||
| Assisted Living Facility | 310400000X | |||
| Respite Care | 385H00000X | Primary |
Addresses
Primary practice location
3207 67TH Ave N
Brooklyn Center, MN 55429-1823
Mailing address
17119 72ND Ave N
Maple Grove, MN 55311-4565
Phone (612) 590-0154
National Provider Directory
National Provider Directory- Tax ID family
- Sunshine Supportive Services
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Case Management Agency
- Brooklyn Center, MN
- NPI 1770456089
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1750032000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1750032000000",
"number": "1003702929",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17119 72ND AVE N",
"city": "MAPLE GROVE",
"state": "MN",
"postal_code": "553114565",
"telephone_number": "612-590-0154"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3207 67TH AVE N",
"city": "BROOKLYN CENTER",
"state": "MN",
"postal_code": "554291823",
"telephone_number": "612-590-0154"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SUNSHINE SUPPORTIVE SERVICES",
"organizational_subpart": "NO",
"enumeration_date": "2025-06-16",
"last_updated": "2025-06-16",
"certification_date": "2025-06-16",
"status": "A",
"authorized_official_last_name": "NYAMBANE",
"authorized_official_first_name": "ELIJAH",
"authorized_official_middle_name": "GEORGE",
"authorized_official_title_or_position": "OWNER/CEO",
"authorized_official_telephone_number": "612-590-0154"
},
"taxonomies": [
{
"code": "251E00000X",
"taxonomy_group": "",
"desc": "Home Health",
"state": null,
"license": null,
"primary": false
},
{
"code": "251J00000X",
"taxonomy_group": "",
"desc": "Nursing Care",
"state": null,
"license": null,
"primary": false
},
{
"code": "310400000X",
"taxonomy_group": "",
"desc": "Assisted Living Facility",
"state": null,
"license": null,
"primary": false
},
{
"code": "385H00000X",
"taxonomy_group": "",
"desc": "Respite Care",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brooklyn Center, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.