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General NPI Number Information
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NPI Number | 1629875638
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Entity Type | Organization
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Legal Business Name | ORIVIX HEALTH LLC
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Dates
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Enumeration Date | 02/26/2025
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Last Update Date | 02/26/2025
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Provider Practice Location Address
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Address Line | 5424 LOGAN AVE N
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City | BROOKLYN CENTER
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State | MN
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Zip | 55430-3023
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Country | US
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Telephone | 763-447-5494
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Fax |
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Provider Business Mailing Address
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Address Line | 11519 JONQUIL ST NW
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City | COON RAPIDS
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State | MN
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Zip | 55433-2863
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | LALD
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Name | MR. SHADRACK BRADFORD ORURE
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Credential | RN
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Telephone | 763-447-5494
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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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