Organization Active NPI

Life Insurance Agency, Inc.

Doing business as Home Healthcare Agency

  • Home Health Agency
  • Roseville, MN
National Provider Identifier
1063762169
Registry record updated Mar 14, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
LIFE INSURANCE AGENCY, INC.
Doing business as
Home Healthcare Agency
Practice address
2489 Rice St Ste 295
Suite 295
Roseville, MN 55113-3738
Phone
(952) 388-7128
Fax
(800) 532-1684
NPI assigned
Sep 16, 2012
Last updated
Mar 14, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2016

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

Authorized official

Name
Mr. Tubtshwm Washington Yang
Title
President
Phone
(952) 388-7128

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X MN Primary
Home Infusion Agency 251F00000X MN
In Home Supportive Care Agency 253Z00000X MN

Addresses

Primary practice location

2489 Rice St Ste 295
Suite 295
Roseville, MN 55113-3738

Mailing address

2489 Rice St Ste 295
Suite 295
Roseville, MN 55113-3738
Phone (952) 388-7128

Other names 1

  • Home Healthcare Agency Doing business as

National Provider Directory

National Provider Directory

Locations

2489 Rice St
Ste 295
Roseville, MN 55113
Phone (952) 388-7128

NPI Registry JSON

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

{
    "created_epoch": "1347753600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1457913600000",
    "number": "1063762169",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2489 RICE ST STE 295",
            "address_2": "SUITE 295",
            "city": "ROSEVILLE",
            "state": "MN",
            "postal_code": "551133738",
            "telephone_number": "952-388-7128",
            "fax_number": "800-532-1684"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2489 RICE ST STE 295",
            "address_2": "SUITE 295",
            "city": "ROSEVILLE",
            "state": "MN",
            "postal_code": "551133738",
            "telephone_number": "952-388-7128",
            "fax_number": "800-532-1684"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFE INSURANCE AGENCY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-09-16",
        "last_updated": "2016-03-14",
        "status": "A",
        "authorized_official_last_name": "YANG",
        "authorized_official_first_name": "TUBTSHWM",
        "authorized_official_middle_name": "WASHINGTON",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "952-388-7128",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "MN",
            "license": null,
            "primary": true
        },
        {
            "code": "251F00000X",
            "taxonomy_group": "",
            "desc": "Home Infusion",
            "state": "MN",
            "license": null,
            "primary": false
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "MN",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Home Healthcare Agency",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Roseville, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2016; 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.