| Radical Recovery Llc | |
|
2323 16th Ave S Ste 308 Moorhead MN 56560-3862 | |
| (218) 284-1515 | |
| (218) 213-8917 |
| Full Name | Radical Recovery Llc |
|---|---|
| Speciality | Counselor - Addiction (substance Use Disorder) |
| Location | 2323 16th Ave S Ste 308, Moorhead, Minnesota |
| Authorized Official Name and Position | Leane Marie Lafrance (OWNER) |
| Authorized Official Contact | 2182778560 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Radical Recovery Llc 2323 16th Ave S Ste 308 Moorhead MN 56560-3862 Ph: (218) 284-1515 | Radical Recovery Llc 2323 16th Ave S Ste 308 Moorhead MN 56560-3862 Ph: (218) 284-1515 |
| NPI Number | 1386117968 |
|---|---|
| Provider Enumeration Date | 01/07/2019 |
| Last Update Date | 01/18/2020 |
| Certification Date | 01/18/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386117968 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | (* (Not Available)) | Primary |
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