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General NPI Number Information
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NPI Number | 1164360293
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Entity Type | Organization
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Legal Business Name | LOVELEAD AL LLC
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Dates
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Enumeration Date | 03/23/2026
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Last Update Date | 03/23/2026
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Provider Practice Location Address
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Address Line | 7357 JENSEN AVE S
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City | COTTAGE GROVE
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State | MN
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Zip | 55016-2282
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Country | US
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Telephone | 612-260-3900
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Fax |
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Provider Business Mailing Address
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Address Line | 7357 JENSEN AVE S
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City | COTTAGE GROVE
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State | MN
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Zip | 55016-2282
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Country | US
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Telephone | 612-260-3900
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Fax | 651-401-9411
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Authorized Official
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Title or Position | RN, ALD
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Name | NADESH NKIESEH
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Credential | RN, ALD
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Telephone | 651-424-7153
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number |
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License Number State |
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