RIVER OF LIFE SERVICES LLC NPI 1144400011

NPI Information

RIVER OF LIFE SERVICES LLC is an addiction medicine internal medicine in St Louis Park, MN. The provider is an internist doctor of osteopathy that specializes in the treatment of addiction disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine can obtain a Certificate of Added Qualifications in the field of Addiction Medicine. RIVER OF LIFE SERVICES LLC NPI is 1144400011. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As River Of Life Services.

The provider's business location address is:

6200 EXCELSIOR BLVD
#202
ST LOUIS PARK, MN
ZIP 55416-730
Phone: (952) 548-9344
Fax: (952) 548-9344

The provider's authorized official is Hayden Donaldson Severin .
The authorized official title is Addictionology/asam Certified and has the following contact phone number (952) 548-9344.

The enumeration date for this NPI number is 11/8/2007 and was last updated on 11/8/2007.

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