Provider Demographics
NPI:1285973610
Name:LILI GROUP INC
Entity type:Organization
Organization Name:LILI GROUP INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:YUSSUF
Authorized Official - Middle Name:
Authorized Official - Last Name:HAMID
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:612-616-5729
Mailing Address - Street 1:PO BOX 8705
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55408-0705
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3947 EXCELSIOR BLVD
Practice Address - Street 2:119
Practice Address - City:ST LOUIS PARK
Practice Address - State:MN
Practice Address - Zip Code:55416-4755
Practice Address - Country:US
Practice Address - Phone:612-616-5729
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-05
Last Update Date:2013-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN360751251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health