Organization Active NPI

Sunshine Assisted Living Services LLC

  • Assisted Living Facility
  • Bloomington, MN
National Provider Identifier
1720624810
Registry record updated Nov 23, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
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

Updated by the provider on Nov 23, 2019

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)CodeLicenseStatePrimary
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 NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
24D2178443Sunshine Assisted Living Services LLC9540 Columbus Ave South, Bloomington, MN 55420Certificate of waiverFeb 3, 2028

National Provider Directory

National Provider Directory

NPI 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.

Verify at the official NPI Registry.