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 |