Healthcare Provider Details

I. General information

NPI: 1215753546
Provider Name (Legal Business Name): SUNSET HOME HEALTHCARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/03/2024
Last Update Date: 04/25/2025
Certification Date: 04/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5701 SHINGLE CREEK PKWY # 365
BROOKLYN CENTER MN
55430-2467
US

IV. Provider business mailing address

5701 SHINGLE CREEK PKWY # 365
BROOKLYN CENTER MN
55430-2467
US

V. Phone/Fax

Practice location:
  • Phone: 651-278-1417
  • Fax:
Mailing address:
  • Phone: 651-278-1417
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State

VIII. Authorized Official

Name: HANA OSMAN OMAR
Title or Position: OWNER
Credential:
Phone: 651-278-1417