Active NPI
Live Well MN LLC
Doing business as Live Well MN Home Healthcare
- Home Health Agency
- Edina, MN
National Provider Identifier
1225706799
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Health Agency
- Legal business name
- LIVE WELL MN LLC
- Doing business as
- Live Well MN Home Healthcare
- Practice address
- 7400 Metro Blvd Ste 100-8
Edina, MN 55439-2316 - Phone
- (612) 460-5094
- Fax
- (952) 303-5273
- NPI assigned
- Aug 31, 2021
- Last updated
- Aug 31, 2021
- Organization subpart
- Yes
- Parent organization
- LIVE WELL MN LLC
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Isaak Rooble
- Title
- Owner
- Phone
- (612) 800-4088
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Agency | 251E00000X | NU | Primary |
Addresses
Primary practice location
7400 Metro Blvd Ste 100-8
Edina, MN 55439-2316
Mailing address
7400 Metro Blvd Ste 100-8
Edina, MN 55439-2316
Phone (612) 460-5094
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| X314 | Other | MN | STATE DRIVERS LICENSE |
Other names 1
- LIVE WELL MN HOME HEALTHCARE
National Provider Directory
National Provider Directory- Tax ID family
- Live Well MN
- Part of
- Live Well MN
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
Ownership & related parties
Parent organization (reported in NPPES) 1
This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1630368000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1630368000000",
"number": "1225706799",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7400 METRO BLVD STE 100-8",
"city": "EDINA",
"state": "MN",
"postal_code": "554392316",
"telephone_number": "612-460-5094",
"fax_number": "952-303-5273"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7400 METRO BLVD STE 100-8",
"city": "EDINA",
"state": "MN",
"postal_code": "554392316",
"telephone_number": "612-460-5094",
"fax_number": "952-303-5273"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "LIVE WELL MN LLC",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "LIVE WELL MN LLC",
"enumeration_date": "2021-08-31",
"last_updated": "2021-08-31",
"certification_date": "2021-08-16",
"status": "A",
"authorized_official_last_name": "ROOBLE",
"authorized_official_first_name": "ISAAK",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "612-800-4088"
},
"taxonomies": [
{
"code": "251E00000X",
"taxonomy_group": "",
"desc": "Home Health",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE DRIVERS LICENSE",
"identifier": "X314",
"state": "MN"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "LIVE WELL MN HOME HEALTHCARE",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Edina, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.