Provider Demographics
NPI:1619586880
Name:LIFEFORCE SERVICES INC
Entity Type:Organization
Organization Name:LIFEFORCE SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:FAISAL
Authorized Official - Middle Name:
Authorized Official - Last Name:AIDEED
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:952-649-0512
Mailing Address - Street 1:14199 VALLEY VIEW RD APT 204
Mailing Address - Street 2:
Mailing Address - City:EDEN PRAIRIE
Mailing Address - State:MN
Mailing Address - Zip Code:55344-1926
Mailing Address - Country:US
Mailing Address - Phone:952-649-0512
Mailing Address - Fax:
Practice Address - Street 1:2003 10TH AVE S STE 6
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55404-6606
Practice Address - Country:US
Practice Address - Phone:952-649-0513
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-23
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN6739524Medicaid