Healthcare Provider Details

I. General information

NPI: 1144101411
Provider Name (Legal Business Name): SUNRISE ADULT DAYCARE CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/11/2025
Last Update Date: 09/11/2025
Certification Date: 09/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

570 1ST ST SE STE 103
SAINT CLOUD MN
56304-0800
US

IV. Provider business mailing address

570 1ST ST SE STE 103
SAINT CLOUD MN
56304-0800
US

V. Phone/Fax

Practice location:
  • Phone: 763-656-9334
  • Fax: 320-217-2107
Mailing address:
  • Phone: 763-656-9334
  • Fax: 320-217-2107

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: KAHIYE HUSSEIN ABDI
Title or Position: OWNER
Credential:
Phone: 763-656-9334