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General NPI Number Information
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NPI Number | 1700744901
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Entity Type | Organization
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Legal Business Name | RADIANT LIVING HOMES LLC
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Dates
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Enumeration Date | 01/14/2026
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Last Update Date | 01/14/2026
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Provider Practice Location Address
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Address Line | 640 4TH AVE NE
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City | OSSEO
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State | MN
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Zip | 55369-1148
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Country | US
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Telephone | 763-222-9450
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Fax |
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Provider Business Mailing Address
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Address Line | 11541 PINERIDGE WAY N
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City | DAYTON
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State | MN
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Zip | 55327-2603
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Country | US
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Telephone | 763-222-9450
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | AJIBOLA AJAYI
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Credential |
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Telephone | 763-222-9450
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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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