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SUNRISE RESIDENTIAL SERVICES LLC
NPI 1871200121
Assisted Living Facility in Roseville, MN

Active since November 04, 2022CLIA 24D2162939 · Waiver
216 MAPLE LN, ROSEVILLE, MN 55113(651) 528-6363(612) 314-8590 Get Directions Write a Review

NPPES record last updated: November 4, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Sunrise Residential Services Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SUNRISE RESIDENTIAL SERVICES LLC (NPI 1871200121) is a healthcare organization registered as an assisted living facility in Roseville, Minnesota and active in the NPI registry since November 2022. The organization holds a CLIA Waiver certificate valid through March 4, 2027 and lists Mustafa H Musse, Director, as its authorized official.

NPPES Registry Identity

NPI1871200121
Entity TypeOrganization
Primary Taxonomy310400000X
Legal Business NameSUNRISE RESIDENTIAL SERVICES LLC
Location Address216 MAPLE LNRoseville, MN 55113-2429
Mailing Address216 Maple LnRoseville, MN 55113-2429 · (651) 528-6363 · Fax (612) 314-8590
Phone(651) 528-6363
Fax(612) 314-8590
Organization SubpartNo
Authorized OfficialMustafa H MusseDirector · (952) 465-8087
Enumeration DateNovember 4, 2022
NPPES CertifiedNovember 2, 2022
✔ NPI 1871200121 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyAssisted Living FacilityNursing & Custodial Care Facilities
Taxonomy Code310400000X
Definition
A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being.
216 MAPLE LN, Roseville, MN 55113
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CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 24D2162939

Sunrise Residential Services · Roseville, MN
Active · expires Mar 4, 2027
CLIA Number24D2162939
Laboratory TypeAssisted Living Facility
Certificate Effective DateMarch 5, 2025
Certificate Expiration DateMarch 4, 2027
Laboratory DirectorMustafa H. Musse
Laboratory Phone(952) 465-8087
Laboratory LocationSunrise Residential Services216 Maple Ln, Roseville, MN 55113
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

SUNRISE RESIDENTIAL SERVICES LLC
Assisted Living Facility
216 MAPLE LN
ROSEVILLE, MN 55113
Ramsey County (206) 458-3553

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Sunrise Residential Services LLC's NPI number?

The NPI number for Sunrise Residential Services LLC is 1871200121. It was assigned to this organization in the NPPES registry on November 4, 2022.

Where is Sunrise Residential Services LLC located?

Sunrise Residential Services LLC is located at 216 Maple Ln, Roseville, MN 55113. The listed phone number is (651) 528-6363.

What is Sunrise Residential Services LLC's specialty?

The primary specialty registered for this NPI is Assisted Living Facility with taxonomy code 310400000X.

Does Sunrise Residential Services LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 24D2162939) is associated with this NPI, valid through March 4, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Sunrise Residential Services LLC was last updated on November 4, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.