Healthcare Provider Details

I. General information

NPI: 1124992532
Provider Name (Legal Business Name): SUNRISE ASSISTING LIVING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/30/2025
Last Update Date: 09/30/2025
Certification Date: 09/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7708 45 1/2 AVE N
NEW HOPE MN
55428-4904
US

IV. Provider business mailing address

7708 45 1/2 AVE N
NEW HOPE MN
55428-4904
US

V. Phone/Fax

Practice location:
  • Phone: 612-217-2907
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code311ZA0620X
TaxonomyAdult Care Home Facility
License Number
License Number State

VIII. Authorized Official

Name: MALYUN ABDI HASSAN
Title or Position: OWNER
Credential:
Phone: 612-217-2907