# LIFE ALLIANCE, LLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Other names:** Life Alliance, LLC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1124542360
- **Authorized official:** ABDISALLAM A ABDULLE (CEO)
- **Authorized official phone:** (952) 777-4625

## Contact information

- **Practice address:** 8609 LYNDALE AVE S, SUITE 213C, BLOOMIGTON, MN 55420-5542
- **Practice address phone:** (952) 777-4625
- **Practice address fax:** (952) 777-4627
- **Mailing address:** 8609 LYNDALE AVE S STE 213C, MINNEAPOLIS, MN 55420-2769
- **Mailing address phone:** (612) 200-9466
- **Mailing address fax:** (952) 777-4627

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YM0800X | Mental Health Counselor | — | NULL | — |
| 101YM0800X | Mental Health Counselor | — | — | — |
| 251C00000X | Developmentally Disabled Services Day Training Agency | — | NULL | — |
| 252Y00000X | Early Intervention Provider Agency | 1087364-1-HCBS | MN | — |
| 252Y00000X | Early Intervention Provider Agency | — | NULL | Yes |

## Other

- **Enumeration date:** 07/31/2017
- **Last updated:** 07/31/2017