Organization
LIVE IN CARE HOME HEALTH LIMITED LIABILITY COMPANY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KEOKHONMA PHOMSOUKHA (MANAGER)
(763) 843-5996
Entity
Organization
Contact information
Practice address
8625 CHEROKEE DR N, BROOKLYN PARK, MN 55428-1916
(763) 843-5996
Mailing address
7839 85TH CT N, BROOKLYN PARK, MN 55445-2156
(763) 843-5996
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Enumeration date
08/18/2023
Last updated
08/18/2023
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