| Living Free Recovery Services, Llc | |
|
9201 75th Avenue North Brooklyn Park MN 55428 | |
| (763) 315-7000 | |
| (763) 315-7177 |
| Full Name | Living Free Recovery Services, Llc |
|---|---|
| Speciality | Counselor - Addiction (substance Use Disorder) |
| Location | 9201 75th Avenue North, Brooklyn Park, Minnesota |
| Authorized Official Name and Position | Treena Haase (PRESIDENT) |
| Authorized Official Contact | 7633157174 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Living Free Recovery Services, Llc 9201 75th Avenue North Brooklyn Park MN 55428 Ph: (763) 315-7000 | Living Free Recovery Services, Llc 9201 75th Avenue North Brooklyn Park MN 55428 Ph: (763) 315-7000 |
| NPI Number | 1144227430 |
|---|---|
| Provider Enumeration Date | 07/01/2005 |
| Last Update Date | 11/01/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144227430 | NPI | - | NPPES |
| 251922400 | Medicaid | MN | |
| 0C20LI | Other | MN | BCBS OF MN |
| 8442759 | Other | MN | UBH - ADULT |
| 8446051 | Other | MN | UBH- ASSESSMENT ONLY |
| 8442760 | Other | MN | UBH - ADOLESCENT |
| 8442761 | Other | FM | UBH - RELAPSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | 830992-2-CDT (Minnesota) | Primary |
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