Live in Care Home Health Limited Liability Company

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

LIVE IN CARE HOME HEALTH LIMITED LIABILITY COMPANY

Practice address

8625 Cherokee Dr N
Brooklyn Park, MN 55428-1916

Phone

(763) 843-5996

NPI assigned

Aug 18, 2023

Organization subpart

No

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

Authorized official

Name

Keokhonma Phomsoukha

Title

Manager

Phone

(763) 843-5996

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1692316800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1692316800000",
    "number": "1053194357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7839 85TH CT N",
            "city": "BROOKLYN PARK",
            "state": "MN",
            "postal_code": "554452156",
            "telephone_number": "763-843-5996"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8625 CHEROKEE DR N",
            "city": "BROOKLYN PARK",
            "state": "MN",
            "postal_code": "554281916",
            "telephone_number": "763-843-5996"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIVE IN CARE HOME HEALTH LIMITED LIABILITY COMPANY",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-08-18",
        "last_updated": "2023-08-18",
        "certification_date": "2023-08-18",
        "status": "A",
        "authorized_official_last_name": "PHOMSOUKHA",
        "authorized_official_first_name": "KEOKHONMA",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "763-843-5996"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2023; 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.