=====================================================
General NPI Number Information
=====================================================
NPI Number | 1962393751
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | LIRA RECOVERY LL
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/10/2025
-----------------------------------------------------
Last Update Date | 07/10/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 16107 DODD LN
-----------------------------------------------------
City | ROSEMOUNT
-----------------------------------------------------
State | MN
-----------------------------------------------------
Zip | 55068-1364
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 619-519-5633
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 16026 ESTATE LN
-----------------------------------------------------
City | LAKEVILLE
-----------------------------------------------------
State | MN
-----------------------------------------------------
Zip | 55044-2269
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 619-549-7911
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | MANAGER
-----------------------------------------------------
Name | FARHIYA ABDI
-----------------------------------------------------
Credential | RN
-----------------------------------------------------
Telephone | 619-519-5633
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251B00000X
-----------------------------------------------------
Taxonomy Name | Case Management Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 251J00000X
-----------------------------------------------------
Taxonomy Name | Nursing Care Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------