Organization
LIVE WELL MN LLC
Active
Parent organization
LIVE WELL MN LLC
Other names
LIVE WELL MN HOME HEALTHCARE
Organization subpart
Yes
Provider details
NPI number
Legal business name
LIVE WELL MN LLC
Authorized official
ISAAK ROOBLE (OWNER)
(612) 800-4088
Entity
Organization
Contact information
Practice address
7400 METRO BLVD STE 100-8, EDINA, MN 55439-2316
(612) 460-5094
(952) 303-5273
Mailing address
7400 METRO BLVD STE 100-8, EDINA, MN 55439-2316
(612) 460-5094
(952) 303-5273
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
X314
STATE DRIVERS LICENSE
MN
Enumeration date
08/31/2021
Last updated
08/31/2021
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