# LIFE MADE EASY HEALTHCARE L.L.C

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

## Provider details

- **NPI number:** 1891294203
- **Authorized official:** JUSTIN ROBERT MOE (OWNER)
- **Authorized official phone:** (612) 554-0740

## Contact information

- **Practice address:** 13355 GEORGE WEBER DR STE B, ROGERS, MN 55374-4864
- **Practice address phone:** (612) 554-0740
- **Practice address fax:** (612) 278-2022
- **Mailing address:** 7346 HAMES WAY, EDEN PRAIRIE, MN 55346-4215
- **Mailing address phone:** (612) 554-0740
- **Mailing address fax:** (612) 278-2022

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 163WH0200X | Home Health Registered Nurse | R-2096708 | MN | Yes |

## Other

- **Enumeration date:** 02/12/2018
- **Last updated:** 02/12/2018