Active NPI
Live Life Well Sevices LLC
- Case Management Registered Nurse
- Fridley, MN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Case Management Registered Nurse
- Legal business name
- LIVE LIFE WELL SEVICES LLC
- Doing business as
- Live Life Well Sevices LLC
- Practice address
- 1469 Gardena Ave NE
Fridley, MN 55432-5815 - Phone
- (763) 923-3051
- NPI assigned
- Oct 1, 2020
- Last updated
- Jul 14, 2022
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Roda Hussien Ali
- Title
- Owner
- Phone
- (763) 923-3051
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Case Management Registered Nurse | 163WC0400X | NU | Primary |
Addresses
Primary practice location
1469 Gardena Ave NE
Fridley, MN 55432-5815
Mailing address
1469 Gardena Ave NE
Fridley, MN 55432-5815
Phone (763) 923-3051
Other names 1
- LIVE LIFE WELL SEVICES LLC
National Provider Directory
National Provider Directory- Tax ID family
- Live Life Well Sevices LLC
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Case Management Agency
- Fridley, MN
- NPI 1912631862
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Case Management Registered Nurse
- Fridley, MN
- NPI 1568196418
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1601510400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1657756800000",
"number": "1093312118",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1469 GARDENA AVE NE",
"city": "FRIDLEY",
"state": "MN",
"postal_code": "554325815",
"telephone_number": "763-923-3051"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1469 GARDENA AVE NE",
"city": "FRIDLEY",
"state": "MN",
"postal_code": "554325815",
"telephone_number": "763-923-3051"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "LIVE LIFE WELL SEVICES LLC",
"organizational_subpart": "NO",
"enumeration_date": "2020-10-01",
"last_updated": "2022-07-14",
"certification_date": "2022-07-14",
"status": "A",
"authorized_official_last_name": "ALI",
"authorized_official_first_name": "RODA",
"authorized_official_middle_name": "HUSSIEN",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "763-923-3051"
},
"taxonomies": [
{
"code": "163WC0400X",
"taxonomy_group": "",
"desc": "Registered Nurse, Case Management",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "LIVE LIFE WELL SEVICES LLC",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "LIVE LIFE WELL SEVICES LLC",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Fridley, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.