Livewell Home Residential Services LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

LIVEWELL HOME RESIDENTIAL SERVICES LLC

Practice address

2647 Margaret Ave E
Maplewood, MN 55119-4128

Phone

(612) 532-7918

NPI assigned

Dec 15, 2022

Last updated

Dec 15, 2022By 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

Gemedi Bakuto

Title

Ceo

Phone

(612) 532-7918

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1671062400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1671062400000",
    "number": "1265144828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2647 MARGARET AVE E",
            "city": "MAPLEWOOD",
            "state": "MN",
            "postal_code": "551194128",
            "telephone_number": "612-532-7918"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2647 MARGARET AVE E",
            "city": "MAPLEWOOD",
            "state": "MN",
            "postal_code": "551194128",
            "telephone_number": "612-532-7918"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIVEWELL HOME RESIDENTIAL SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-12-15",
        "last_updated": "2022-12-15",
        "certification_date": "2022-12-14",
        "status": "A",
        "authorized_official_last_name": "BAKUTO",
        "authorized_official_first_name": "GEMEDI",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "612-532-7918"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Assisted Living Facility in Maplewood, MN
• Providers in Maplewood, MN by specialty
• Assisted Living Facility in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 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.

Verify at the official NPI Registry.