# LIFE JOURNEY SERVICES LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1477000537
- **Authorized official:** BISHARO JAAMAC YUSSUF (FOUNDER)
- **Authorized official phone:** (612) 242-7843

## Contact information

- **Practice address:** 1910 UNIVERSITY AVE W, SAINT PAUL, MN 55104-3426
- **Practice address phone:** (612) 242-7843
- **Mailing address:** 1910 UNIVERSITY AVE W, SAINT PAUL, MN 55104-3426
- **Mailing address phone:** (612) 242-7843

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 252Y00000X | Early Intervention Provider Agency | — | NULL | Yes |

## Other

- **Enumeration date:** 09/07/2016
- **Last updated:** 09/07/2016