Organization
LIFE IN RECOVERY, LLC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DOREEN MARIE LOOMIS (OWNER)
(320) 632-2598
Entity
Organization
Contact information
Practice address
304 8TH ST SE, LITTLE FALLS, MN 56345-3241
(320) 360-4755
(320) 632-2781
Mailing address
304 8TH ST SE, LITTLE FALLS, MN 56345-3241
(320) 360-4755
(320) 632-2781
Taxonomy
Speciality
Code
Description
License number
State
302F00000X
Exclusive Provider Organization
Primary
9021
MN
Other
Enumeration date
01/03/2008
Last updated
01/03/2008
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