| Divine Life Llc | |
|
506 Freeport Ave Nw Elk River MN 55330-4611 | |
| (763) 200-4006 | |
| Not Available |
| Full Name | Divine Life Llc |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 506 Freeport Ave Nw, Elk River, Minnesota |
| Authorized Official Name and Position | John Carl Torkelson (CEO) |
| Authorized Official Contact | 7632004006 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Divine Life Llc 506 Freeport Ave Nw Elk River MN 55330-4611 Ph: (763) 200-4006 | Divine Life Llc 506 Freeport Ave Nw Elk River MN 55330-4611 Ph: (763) 200-4006 |
| NPI Number | 1992538052 |
|---|---|
| Provider Enumeration Date | 08/23/2024 |
| Last Update Date | 08/23/2024 |
| Certification Date | 08/23/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992538052 | NPI | - | NPPES |
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