Provider Demographics
NPI:1346786035
Name:FIRST NATIONS, LLC
Entity Type:Organization
Organization Name:FIRST NATIONS, LLC
Other - Org Name:CIRCLE OF LIFE HOME CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:TIM
Authorized Official - Middle Name:
Authorized Official - Last Name:LIVELY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:651-633-7300
Mailing Address - Street 1:2586 7TH AVE E
Mailing Address - Street 2:SUITE 302
Mailing Address - City:NORTH ST PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55109-3083
Mailing Address - Country:US
Mailing Address - Phone:651-633-7300
Mailing Address - Fax:651-633-7301
Practice Address - Street 1:2586 7TH AVE E
Practice Address - Street 2:SUITE 302
Practice Address - City:NORTH ST PAUL
Practice Address - State:MN
Practice Address - Zip Code:55109-3083
Practice Address - Country:US
Practice Address - Phone:651-633-7300
Practice Address - Fax:651-633-7301
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-18
Last Update Date:2023-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251E00000XAgenciesHome Health
No311Z00000XNursing & Custodial Care FacilitiesCustodial Care Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ378177Medicaid
MNA430029700Medicaid
NM45471746Medicaid