Active NPI
Sunshine Assisted Living Services LLC
- Assisted Living Facility
- Bloomington, MN
National Provider Identifier
1720624810
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Assisted Living Facility
- Legal business name
- SUNSHINE ASSISTED LIVING SERVICES LLC
- Practice address
- 9540 Columbus Ave S
Bloomington, MN 55420 - Phone
- (952) 457-7992
- NPI assigned
- Nov 23, 2019
- 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
- Abdulahi Abdirahman
- Title
- Owner
- Phone
- (952) 457-7992
Specialties & licenses 5
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Agency | 251E00000X | |||
| Nursing Care Agency | 251J00000X | |||
| Assisted Living Facility | 310400000X | Primary | ||
| Durable Medical Equipment & Medical Supplies | 332B00000X | |||
| Non-emergency Medical Transport (VAN) | 343900000X |
Addresses
Primary practice location
9540 Columbus Ave S
Bloomington, MN 55420
Mailing address
9540 Columbus Ave S
Bloomington, MN 55420
Phone (952) 457-7992
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 24D2178443 | Sunshine Assisted Living Services LLC | Certificate of waiver | Feb 3, 2028 |
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1574467200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1574467200000",
"number": "1720624810",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9540 COLUMBUS AVE S",
"city": "BLOOMINGTON",
"state": "MN",
"postal_code": "55420",
"telephone_number": "952-457-7992"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9540 COLUMBUS AVE S",
"city": "BLOOMINGTON",
"state": "MN",
"postal_code": "55420",
"telephone_number": "952-457-7992"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SUNSHINE ASSISTED LIVING SERVICES LLC",
"organizational_subpart": "NO",
"enumeration_date": "2019-11-23",
"last_updated": "2019-11-23",
"status": "A",
"authorized_official_last_name": "ABDIRAHMAN",
"authorized_official_first_name": "ABDULAHI",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "952-457-7992"
},
"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": true
},
{
"code": "332B00000X",
"taxonomy_group": "",
"desc": "Durable Medical Equipment & Medical Supplies",
"state": null,
"license": null,
"primary": false
},
{
"code": "343900000X",
"taxonomy_group": "",
"desc": "Non-emergency Medical Transport (VAN)",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Bloomington, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.