Actively Living Life Inc

Primary specialty

Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X

Legal business name

ACTIVELY LIVING LIFE INC

Practice address

1187 Blackhawk Dr SW
Hutchinson, MN 55350

Phone

(952) 215-4616

Fax

(952) 974-7851

NPI assigned

May 29, 2013

Last updated

Jul 6, 2018By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Luke Laidlaw, OWNER/DIRECTOR

Title

President

Phone

(320) 295-2460

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1369785600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1530835200000",
    "number": "1023455243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1187 BLACKHAWK DR SW",
            "city": "HUTCHINSON",
            "state": "MN",
            "postal_code": "55350",
            "telephone_number": "952-215-4616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1187 BLACKHAWK DR SW",
            "city": "HUTCHINSON",
            "state": "MN",
            "postal_code": "55350",
            "telephone_number": "952-215-4616",
            "fax_number": "952-974-7851"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ACTIVELY LIVING LIFE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-05-29",
        "last_updated": "2018-07-06",
        "status": "A",
        "authorized_official_last_name": "LAIDLAW",
        "authorized_official_first_name": "LUKE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "320-295-2460",
        "authorized_official_credential": "OWNER/DIRECTOR"
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "MN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Hutchinson, MN
• Providers in Hutchinson, MN by specialty
• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.