LIFEWAY HEALTH & WELLNESS LLC NPI 1598443723

NPI Information

  • NPI: 1598443723
  • Provider Name: LIFEWAY HEALTH & WELLNESS LLC
  • Classification: Clinic/Center - 261QP2300X
  • Specialization: Primary Care
  • Entity Type: Organization
  • CLIA Number: 24D2288544
  • Address: 6964 SYCAMORE CT N
    MAPLE GROVE, MN
    ZIP 55369
  • Phone: (763) 438-3814

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NPI Details

LIFEWAY HEALTH & WELLNESS LLC is a primary care clinic center in Maple Grove, MN. LIFEWAY HEALTH & WELLNESS LLC NPI is 1598443723. The provider is registered as an organization entity type.

The provider's business location address is:

6964 SYCAMORE CT N
MAPLE GROVE, MN
ZIP 55369
Phone: (763) 438-3814

The provider's authorized official is Stacy Woodard .
The authorized official title is Ceo and has the following contact phone number (763) 438-3814.

The CLIA number assigned to this NPI record is 24D2288544 - practitioner other with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 7/7/2023 and was last updated on 11/11/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QP2300XClinic/CenterPrimary CareYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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