# RIVER OF LIFE SERVICES LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** River of Life Services
- **Organization subpart:** No

## Provider details

- **NPI number:** 1144400011
- **Authorized official:** DR. HAYDEN DONALDSON SEVERIN MD (ADDICTIONOLOGY/ASAM CERTIFIED)
- **Authorized official phone:** (952) 548-9344

## Contact information

- **Practice address:** 6200 EXCELSIOR BLVD, \#202, ST LOUIS PARK, MN 55416-2730
- **Practice address phone:** (952) 548-9344
- **Practice address fax:** (952) 548-9344
- **Mailing address:** 6200 EXCELSIOR BLVD, \#202, ST LOUIS PARK, MN 55416-2730
- **Mailing address phone:** (952) 548-9344
- **Mailing address fax:** (952) 548-9344

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207RA0401X | Addiction Medicine (Internal Medicine) Physician | 45852 | MN | Yes |

## Other

- **Enumeration date:** 11/08/2007
- **Last updated:** 11/08/2007