River of Life Services LLC
NPI #1144400011 in St Louis Park, Minnesota
Provider Information
- NPI Number
- 1144400011
- Entity Type
- Organization
- Organization Name
- River of Life Services LLC
- Primary Specialty
- Internal Medicine - Addiction Medicine
- Enumeration Date
- Nov 8, 2007
- Last Updated
- Nov 8, 2007
Practice Location
- Address
- 6200 EXCELSIOR BLVD
- Address 2
- #202
- City
- St Louis Park
- State
- Minnesota
- ZIP Code
- 55416-2730
- Phone
- (952) 548-9344
Authorized Official
- Name
- DR. HAYDEN DONALDSON SEVERIN, MD
- Title
- ADDICTIONOLOGY/ASAM CERTIFIED
- Phone
- (952) 548-9344
Specialties & Taxonomy Codes
| Specialty |
|---|
| Internal Medicine - Addiction Medicine — Addiction Medicine |
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