Provider Demographics
NPI:1821518929
Name:AS THE SUN
Entity Type:Organization
Organization Name:AS THE SUN
Other - Org Name:SOJOURN COUNSELING GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SABRINA
Authorized Official - Middle Name:
Authorized Official - Last Name:LERE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:320-905-4345
Mailing Address - Street 1:2120 60TH AVE NE
Mailing Address - Street 2:
Mailing Address - City:WILLMAR
Mailing Address - State:MN
Mailing Address - Zip Code:56201-9140
Mailing Address - Country:US
Mailing Address - Phone:320-905-4345
Mailing Address - Fax:507-218-8492
Practice Address - Street 1:3732 LAKESIDE AVENUE
Practice Address - Street 2:SUITE 202
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89509-8950
Practice Address - Country:US
Practice Address - Phone:320-905-4345
Practice Address - Fax:320-905-4345
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-21
Last Update Date:2022-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVPC0150101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV1881936284Medicaid