Healthcare Provider Details

I. General information

NPI: 1346786035
Provider Name (Legal Business Name): FIRST NATIONS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/18/2017
Last Update Date: 05/12/2023
Certification Date: 05/12/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2586 7TH AVE E SUITE 302
NORTH ST PAUL MN
55109-3083
US

IV. Provider business mailing address

2586 7TH AVE E SUITE 302
NORTH ST PAUL MN
55109-3083
US

V. Phone/Fax

Practice location:
  • Phone: 651-633-7300
  • Fax: 651-633-7301
Mailing address:
  • Phone: 651-633-7300
  • Fax: 651-633-7301

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code311Z00000X
TaxonomyCustodial Care Facility
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: TIM LIVELY
Title or Position: PRESIDENT
Credential:
Phone: 651-633-7300