Organization
LIVE LIFE WELL SEVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RODA HUSSIEN ALI (OWNER)
(763) 923-3051
Entity
Organization
Contact information
Practice address
1469 GARDENA AVE NE, FRIDLEY, MN 55432-5815
(763) 923-3051
Mailing address
1469 GARDENA AVE NE, FRIDLEY, MN 55432-5815
(763) 923-3051
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
Other
Enumeration date
07/14/2022
Last updated
07/14/2022
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