Healthcare Provider Details

I. General information

NPI: 1669382255
Provider Name (Legal Business Name): GOOD START LIVING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/08/2026
Last Update Date: 09/08/2026
Certification Date: 09/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2209 KENNARD ST
MAPLEWOOD MN
55109-2617
US

IV. Provider business mailing address

114 LEONA RIVER TRL
HUTTO TX
78634-2007
US

V. Phone/Fax

Practice location:
  • Phone: 614-584-1537
  • Fax:
Mailing address:
  • Phone: 614-584-1537
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State

VIII. Authorized Official

Name: FOSTER KWAME DZAKAH
Title or Position: PRESIDENT
Credential:
Phone: 614-584-1537