| NPI | 1144400011 |
|---|---|
| Doing Business As | RIVER OF LIFE SERVICES |
| Entity Type | Organization |
| Authorized Contact | HAYDEN DONALDSON SEVERIN Addictionology/Asam Certified 952-548-9344 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RA0401X Internal Medicine, Addiction Medicine (Licence: MN 45852) |
| Enumeration Date | 2007-11-08 |
| Last Update Date | 2007-11-08 |