Life Fountain Home Healthcare, Inc

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

LIFE FOUNTAIN HOME HEALTHCARE, INC

Practice address

418 County Road D East
St. Paul, MN 55117-1218

Phone

(651) 403-6034

Fax

(651) 340-7958

NPI assigned

Jan 18, 2012

Organization subpart

No

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

Authorized official

Name

Mr. Wilmar Delgado-Rodriguez

Title

Ceo

Phone

(651) 271-4092

Specialties & licenses 1

Addresses

Practitioners 3

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.

• Toni Raquel Calvillo

  • Case Manager/Care Coordinator
  • Saint Paul, MN
  • NPI 1639916000
  NPD
• Amber Lee Mike

  • Case Manager/Care Coordinator
  • Saint Paul, MN
  • NPI 1689161887
  NPD
• Jennifer Toscano Cardenas

  • Case Manager/Care Coordinator
  • Saint Paul, MN
  • NPI 1295572667
  NPD

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

{
    "created_epoch": "1326844800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1622592000000",
    "number": "1467723858",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "418 COUNTY ROAD D EAST",
            "city": "ST. PAUL",
            "state": "MN",
            "postal_code": "551171218",
            "telephone_number": "651-403-6034",
            "fax_number": "651-340-7958"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "418 COUNTY ROAD D EAST",
            "city": "ST. PAUL",
            "state": "MN",
            "postal_code": "551171218",
            "telephone_number": "651-403-6034",
            "fax_number": "651-340-7958"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFE FOUNTAIN HOME HEALTHCARE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-18",
        "last_updated": "2021-06-02",
        "certification_date": "2021-06-02",
        "status": "A",
        "authorized_official_last_name": "DELGADO-RODRIGUEZ",
        "authorized_official_first_name": "WILMAR",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "651-271-4092",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Heather Ann Liebswager, LPCC
• Faith Lorraine Liedholm Matsch Hicks, NP
• Hope Diane Lien, BD
• Judith Lies, MS,LMFT
• Life Fountain FMS LLC
• Life in Color Psychotherapy LLC
• Life Journey Services LLC
• Life Ripples LLC (Life Ripples)
• Life-Work Psychotherapy LLC
• Lifeline Coordinating Services, Inc.

• Home Health Agency in Saint Paul, MN
• Providers in Saint Paul, MN by specialty
• Home Health Agency in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 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.

Verify at the official NPI Registry.