First Light Residential Care LLC
NPI #1386297547 in St Louis Park, Minnesota
Provider Information
- NPI Number
- 1386297547
- Entity Type
- Organization
- Organization Name
- First Light Residential Care LLC
- Primary Specialty
- Assisted Living Facility
- Enumeration Date
- Jul 17, 2019
- Last Updated
- Jul 17, 2019
Practice Location
- Address
- 2935 AQUILA AVE S
- City
- St Louis Park
- State
- Minnesota
- ZIP Code
- 55426-2953
- Phone
- (612) 404-7552
Authorized Official
- Name
- SOFIA H MOHAMED
- Title
- OWNER
- Phone
- (612) 404-7552
Specialties & Taxonomy Codes
| Specialty |
|---|
| Durable Medical Equipment & Medical Supplies |
| Non-emergency Medical Transport (VAN) |
| Home Health |
| Nursing Care |
| Assisted Living Facility |
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