NPIMap

Organization Active NPI

Life Long Devotion LLC

  • Adult Care Home Facility
  • Fargo, ND
National Provider Identifier
1821869272
Registry record updated Dec 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Care Home FacilityTaxonomy code 311ZA0620X
Legal business name
LIFE LONG DEVOTION LLC
Practice address
4140 4TH Ave S Apt 1105
Fargo, ND 58103-1193
Phone
(801) 673-5781
NPI assigned
Jan 15, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2024

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

Authorized official

Name
Mohamed Omar
Title
Ceo
Phone
(801) 673-5781

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
In Home Supportive Care Agency 253Z00000X
Adult Care Home Facility 311ZA0620X Primary

Addresses

Primary practice location

4140 4TH Ave S Apt 1105
Fargo, ND 58103-1193

Mailing address

PO Box 10003
Fargo, ND 58106-0003
Phone (801) 673-5781

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1705276800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1733270400000",
    "number": "1821869272",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10003",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581060003",
            "telephone_number": "801-673-5781"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4140 4TH AVE S APT 1105",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581031193",
            "telephone_number": "801-673-5781"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFE LONG DEVOTION LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-01-15",
        "last_updated": "2024-12-04",
        "certification_date": "2024-12-04",
        "status": "A",
        "authorized_official_last_name": "OMAR",
        "authorized_official_first_name": "MOHAMED",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "801-673-5781"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fargo, ND

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2024; 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.