Organization
LIVEWELL HOME RESIDENTIAL SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GEMEDI BAKUTO (CEO)
(612) 532-7918
Entity
Organization
Contact information
Practice address
2647 MARGARET AVE E, MAPLEWOOD, MN 55119-4128
(612) 532-7918
Mailing address
2647 MARGARET AVE E, MAPLEWOOD, MN 55119-4128
(612) 532-7918
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Enumeration date
12/15/2022
Last updated
12/15/2022
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