Active NPI
Sunrise Residential Services LLC
- Assisted Living Facility
- Roseville, MN
National Provider Identifier
1477055796
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Assisted Living Facility
- Legal business name
- SUNRISE RESIDENTIAL SERVICES LLC
- Practice address
- 216 Maple LN
Roseville, MN 55113 - Phone
- (206) 458-3553
- NPI assigned
- Mar 2, 2018
- 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
- Tufah Hassan Moallin
- Title
- Owner/Manager
- Phone
- (206) 458-3553
Specialties & licenses 5
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Agency | 251E00000X | |||
| Nursing Care Agency | 251J00000X | 385493 | MN | |
| In Home Supportive Care Agency | 253Z00000X | 1091521 | MN | |
| Assisted Living Facility | 310400000X | Primary | ||
| Home Delivered Meals | 332U00000X | 1091521 | MN |
Addresses
Primary practice location
216 Maple LN
Roseville, MN 55113
Mailing address
216 Maple LN
Roseville, MN 55113
Phone (206) 458-3553
Other practice location 1
310 E 38th St Suite #206
Minneapolis, MN 55409
Phone (206) 458-3553
National Provider Directory
National Provider DirectoryLocations
310 E 38th St
Ste 206
Minneapolis, MN 55409
Phone (206) 458-3553
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1519948800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1565913600000",
"number": "1477055796",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "216 MAPLE LN",
"city": "ROSEVILLE",
"state": "MN",
"postal_code": "55113",
"telephone_number": "206-458-3553"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "216 MAPLE LN",
"city": "ROSEVILLE",
"state": "MN",
"postal_code": "55113",
"telephone_number": "206-458-3553"
}
],
"practiceLocations": [
{
"address_1": "310 E 38th St Suite #206",
"address_purpose": "LOCATION",
"city": "Minneapolis",
"state": "MN",
"postal_code": "55409",
"country_code": "US",
"telephone_number": "206-458-3553",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"organization_name": "SUNRISE RESIDENTIAL SERVICES LLC",
"organizational_subpart": "NO",
"enumeration_date": "2018-03-02",
"last_updated": "2019-08-16",
"status": "A",
"authorized_official_last_name": "MOALLIN",
"authorized_official_first_name": "TUFAH",
"authorized_official_middle_name": "HASSAN",
"authorized_official_title_or_position": "OWNER/MANAGER",
"authorized_official_telephone_number": "206-458-3553"
},
"taxonomies": [
{
"code": "251E00000X",
"taxonomy_group": "",
"desc": "Home Health",
"state": null,
"license": null,
"primary": false
},
{
"code": "251J00000X",
"taxonomy_group": "",
"desc": "Nursing Care",
"state": "MN",
"license": "385493",
"primary": false
},
{
"code": "253Z00000X",
"taxonomy_group": "",
"desc": "In Home Supportive Care",
"state": "MN",
"license": "1091521",
"primary": false
},
{
"code": "310400000X",
"taxonomy_group": "",
"desc": "Assisted Living Facility",
"state": null,
"license": null,
"primary": true
},
{
"code": "332U00000X",
"taxonomy_group": "",
"desc": "Home Delivered Meals",
"state": "MN",
"license": "1091521",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Roseville, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.