Organization
LIFE MADE EASY HEALTHCARE L.L.C
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JUSTIN ROBERT MOE (OWNER)
(612) 554-0740
Entity
Organization
Contact information
Practice address
13355 GEORGE WEBER DR STE B, ROGERS, MN 55374-4864
(612) 554-0740
(612) 278-2022
Mailing address
7346 HAMES WAY, EDEN PRAIRIE, MN 55346-4215
(612) 554-0740
(612) 278-2022
Taxonomy
Speciality
Code
Description
License number
State
163WH0200X
Home Health Registered Nurse
Primary
R-2096708
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1063911469
NPI
—
Enumeration date
02/12/2018
Last updated
02/12/2018
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