Organization
LIVEWELL HEALTH, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DIANNE HANSEN (PRESIDENT)
(651) 271-6100
Entity
Organization
Contact information
Practice address
732 LARPENTEUR AVE W, SAINT PAUL, MN 55113-6558
(651) 271-6100
Mailing address
1769 LEXINGTON AVE N, N #236, SAINT PAUL, MN 55113-6522
(651) 271-6100
Taxonomy
Speciality
Code
Description
License number
State
163WN1003X
Nutrition Support Registered Nurse
—
—
163WP0000X
Pain Management Registered Nurse
—
—
163WR0400X
Rehabilitation Registered Nurse
Primary
—
—
Other
Enumeration date
07/13/2010
Last updated
07/13/2010
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