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Contact Information

ENRICHED LIVING LLC
301 COUNTY ROAD E2 W
NEW BRIGHTON, MN55112-6859
 Phone: 651-505-6766
 Fax: 651-846-5633
 Website:
Indicates primary specialty

NPI Profile & details for ENRICHED LIVING LLC

NPI # 1780103929
LBN Legal business name ENRICHED LIVING LLC
Authorized official TRYAN JOHNSON - (OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 09/19/2017
Last updated 03/20/2026 - About 3 months ago
Identifiers
MN License # 1086810
MN Medicaid 1086810
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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