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Contact Information

LIFETREE CLINIC
14585 GRAND AVE
SUITE 206
BURNSVILLE, MN55306-5719
 Phone: 952-435-7349
 Fax: 952-417-6159
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Acupuncturist

171100000X
 

Adult Health

364SA2200X 89 Certified Clinical Nurse Specialist
Indicates primary specialty

NPI Profile & details for LIFETREE CLINIC

NPI Number 1972860526
LBN Legal business name LIFETREE CLINIC
Authorized official KYU HONG TAE - (OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 04/20/2012
Last updated 04/17/2018 - About 8 years ago
Identifiers
MN License # 0082
MN License # 1529
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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