Provider Demographics
NPI:1568524205
Name:FOREVER LIFE HOME HEALTH CARE LLP
Entity Type:Organization
Organization Name:FOREVER LIFE HOME HEALTH CARE LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER NURSE
Authorized Official - Prefix:
Authorized Official - First Name:TAMI
Authorized Official - Middle Name:RENAE
Authorized Official - Last Name:LEROY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:952-466-9866
Mailing Address - Street 1:223 WINKLER TRL
Mailing Address - Street 2:
Mailing Address - City:COLOGNE
Mailing Address - State:MN
Mailing Address - Zip Code:55322-8013
Mailing Address - Country:US
Mailing Address - Phone:952-466-9866
Mailing Address - Fax:952-466-9867
Practice Address - Street 1:223 WINKLER TRL
Practice Address - Street 2:
Practice Address - City:COLOGNE
Practice Address - State:MN
Practice Address - Zip Code:55322-8013
Practice Address - Country:US
Practice Address - Phone:952-466-9866
Practice Address - Fax:952-466-9867
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN334526251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health