Divine Life LLC

NPI #1992538052 in Elk River, Minnesota

Provider Information

NPI Number: 1992538052
Entity Type: Organization
Organization Name: Divine Life LLC
Primary Specialty: Counselor - Mental Health
Enumeration Date: Aug 23, 2024
Last Updated: Aug 23, 2024

Practice Location

Address: 506 FREEPORT AVE NW
City: Elk River
State: Minnesota
ZIP Code: 55330-4611
Phone: (763) 200-4006

Authorized Official

Name: JOHN CARL TORKELSON, LMFT
Title: CEO
Phone: (763) 200-4006

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinic/Center - Mental Health (Including Community Mental Health Center) — Mental Health (Including Community Mental Health Center)	261QM0801X
Counselor - Mental Health — Mental Health	101YM0800X	Primary

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