Sunflake

Primary specialty

Physical Disabilities Residential Treatment FacilityTaxonomy code 320700000X

License

EA657799 Issued in MN

Legal business name

SUNFLAKE

Practice address

6525 Central Ave NE Unit 2
Fridley, MN 55432-4653

Phone

(612) 730-7955

NPI assigned

Aug 29, 2014

Last updated

Aug 29, 2014By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Jacob Devney

Title

Owner

Phone

(612) 730-7955

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1409270400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1409270400000",
    "number": "1598165359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6525 CENTRAL AVE NE UNIT 2",
            "city": "FRIDLEY",
            "state": "MN",
            "postal_code": "554324653"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6525 CENTRAL AVE NE UNIT 2",
            "city": "FRIDLEY",
            "state": "MN",
            "postal_code": "554324653",
            "telephone_number": "612-730-7955"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUNFLAKE",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-08-29",
        "last_updated": "2014-08-29",
        "status": "A",
        "authorized_official_last_name": "DEVNEY",
        "authorized_official_first_name": "JACOB",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "612-730-7955"
    },
    "taxonomies": [
        {
            "code": "320700000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Physical Disabilities",
            "state": "MN",
            "license": "EA657799",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David John Streitz, M.D.
• Marcie L Stresemann, LPCC
• David Lloyd Sudduth, M.D.
• Amira Muftah Sufian
• Jennifer Mae Sullivan, WHNP
• Sunrise Residential LLC
• Sunshine Center LLC
• Supervalu Pharmacies Inc (Cub Pharmacy)
• Swana Dental Delivery (S-Thetics Dental)
• Jenna Lyn Szpek, DPT

• Physical Disabilities Residential Treatment Facility in Fridley, MN
• Providers in Fridley, MN by specialty
• Physical Disabilities Residential Treatment Facility in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.