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General NPI Number Information
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NPI Number | 1023828886
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Entity Type | Organization
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Legal Business Name | LV HOME AGENCY
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Dates
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Enumeration Date | 01/13/2025
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Last Update Date | 01/24/2025
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Provider Practice Location Address
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Address Line | 455 MINNESOTA STREET SUITE 1523
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City | SAINT PAUL
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State | MN
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Zip | 55101
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Country | US
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Telephone | 651-319-8781
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Fax |
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Provider Business Mailing Address
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Address Line | 455 MINNESOTA STREET SUITE 1523
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City | SAINT PAUL
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State | MN
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Zip | 55101
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Country | US
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Telephone | 651-319-8781
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | LAWRENCE CAMPBELL
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Credential |
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Telephone | 612-380-0454
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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