Healthcare Provider Details

I. General information

NPI: 1396657342
Provider Name (Legal Business Name): FREE LIVING HEALTH CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/22/2026
Last Update Date: 09/22/2026
Certification Date: 09/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7362 UNIVERSITY AVE NE STE 302
FRIDLEY MN
55432-3150
US

IV. Provider business mailing address

7362 UNIVERSITY AVE NE STE 302
FRIDLEY MN
55432-3150
US

V. Phone/Fax

Practice location:
  • Phone: 612-423-9456
  • Fax:
Mailing address:
  • Phone: 612-423-9456
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: KEYRIA ADEM
Title or Position: OWNER
Credential:
Phone: 612-423-9456