Sunrise Youth Services Inc

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

Legal business name

SUNRISE YOUTH SERVICES INC

Practice address

112 University Dr N Ste L140
Fargo, ND 58102-4635

Phone

(701) 639-3356

NPI assigned

Aug 3, 2024

Organization subpart

No

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

Authorized official

Name

Mason Andrew PetersonNPI 1427887025

Title

Chief Executive Officer

Phone

(701) 639-3356

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Mason Andrew Peterson

  • Nurse's Aide
  • Fargo, ND
  • NPI 1427887025
  NPD Authorized official

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

{
    "created_epoch": "1722643200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1722643200000",
    "number": "1609606805",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112 UNIVERSITY DR N STE L140",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581024635",
            "telephone_number": "701-639-3356"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 UNIVERSITY DR N STE L140",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581024635",
            "telephone_number": "701-639-3356"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUNRISE YOUTH SERVICES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-08-03",
        "last_updated": "2024-08-03",
        "certification_date": "2024-08-03",
        "status": "A",
        "authorized_official_last_name": "PETERSON",
        "authorized_official_first_name": "MASON",
        "authorized_official_middle_name": "ANDREW",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "701-639-3356"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Molly Sundbom, PT, DPT
• Lizette Sunde, DPT
• Bobbie Sunderland, MOTR/L
• Ronald D Sundquist, LPC
• Krenda Jay Sundseth
• Sunset Pier Clinical & Therapeutic Massage
• Sunset Therapy Wheel PLLC
• Sunshine Home Care
• Superior Care LLC
• Jill Suzanne Suppes, MS-CCC/SLP

• General Practice Physician in Fargo, ND
• Providers in Fargo, ND by specialty
• General Practice Physician in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2024; 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.