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Organization
L.D.D., INC.
Active
Organization
L.D.D., INC.
Active
Other names
West Metro Recovery Services
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SAMUEL L. STERN J.D. (EXECUTIVE VICE PRESIDENT)
(763) 531-9488
Entity
Organization
Contact information
Practice address
5810 42ND AVE N, ROBBINSDALE, MN 55422-1634
(763) 531-9488
(763) 531-9591
Mailing address
5810 42ND AVE N, ROBBINSDALE, MN 55422-1634
(763) 531-9488
(763) 531-9591
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
8070981CDT
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
16130
HEALTH PATNERS
MN
01
—
9153WE
BLUE CROSS BLUE SHIELD
MN
Enumeration date
07/18/2006
Last updated
08/22/2020
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