OrganizationActive
Independent Living Solutions
NPI 1659732360 · Home Modifications Contractor · Fridley, MN
Provider details
- NPI number
- 1659732360
- Entity type
- Organization
- Primary specialty
- Home Modifications ContractorOther Service Providers
- Organization subpart
- No
- Authorized official
- Brent Megahan, President(612) 743-7373
- License
- BC630902 (MN)
Specialties & taxonomies
Other Service Providers
Suppliers
- Customized Equipment (DME)332BC3200X
Suppliers
Practice location
7714 Beech St Ne
Fridley, MN 55432-2512
Phone: (612) 743-7373
Fax: (763) 571-5870
Approximate (ZIP-level) locationGet directions
Mailing address
7714 Beech St Ne
Fridley, MN 55432-2512
Registry dates
- Enumerated
- 2016-03-09
- Last updated
- 2024-05-03
- Certified
- 2024-05-03
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.