NPI 1053194357

Live in Care Home Health Limited Liability Company

Organisation Assisted Living Facility Brooklyn Park, MN

Practice location

Address: 8625 Cherokee Dr N, Brooklyn Park, MN 55428-1916
Phone: (763) 843-5996
Mailing address: 7839 85th CT N, Brooklyn Park, MN 55445-2156

Authorised official

Name: Keokhonma Phomsoukha
Title: Manager
Phone: (763) 843-5996

Registered specialties

Assisted Living Facility Primary

Nursing & Custodial Care Facilities Taxonomy 310400000X

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Registry record

NPI: 1053194357
Entity type: Organization
NPI issued: 18 Aug 2023
Record last updated: 18 Aug 2023

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.