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Organization
LIVING FREE RECOVERY SERVICES, LLC
Active
Organization
LIVING FREE RECOVERY SERVICES, LLC
Active
Other names
Living Word Christian Center DBA Living Free Recovery Services
Organization subpart
No
Provider details
NPI number
Authorized official
TREENA HAASE (PRESIDENT)
(763) 315-7174
Entity
Organization
Contact information
Practice address
9201 75TH AVENUE NORTH, BROOKLYN PARK, MN 55428
(763) 315-7000
(763) 315-7177
Mailing address
9201 75TH AVENUE NORTH, BROOKLYN PARK, MN 55428
(763) 315-7000
(763) 315-7177
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
830992-2-CDT
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0C20LI
BCBS OF MN
MN
05
—
251922400
—
MN
01
—
8442759
UBH - ADULT
MN
01
—
8442760
UBH - ADOLESCENT
MN
01
—
8442761
UBH - RELAPSE
FM
01
—
8446051
UBH- ASSESSMENT ONLY
MN
Enumeration date
07/01/2005
Last updated
11/01/2017
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