Provider Demographics
NPI:1629615612
Name:LIVELIFE THERAPY SOLUTIONS
Entity Type:Organization
Organization Name:LIVELIFE THERAPY SOLUTIONS
Other - Org Name:TECHNOLOGY FOR HOME
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PROGRAM DIRECTOR/PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:REDEPENNING
Authorized Official - Suffix:
Authorized Official - Credentials:OTR
Authorized Official - Phone:612-968-0832
Mailing Address - Street 1:8100 PENN AVE S STE 137
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGTON
Mailing Address - State:MN
Mailing Address - Zip Code:55431-1325
Mailing Address - Country:US
Mailing Address - Phone:612-968-0832
Mailing Address - Fax:952-921-8334
Practice Address - Street 1:8100 PENN AVE S STE 137
Practice Address - Street 2:
Practice Address - City:BLOOMINGTON
Practice Address - State:MN
Practice Address - Zip Code:55431-1325
Practice Address - Country:US
Practice Address - Phone:612-968-0832
Practice Address - Fax:952-921-8334
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-09
Last Update Date:2020-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation PractitionerGroup - Multi-Specialty