Organization
ACTIVELY LIVING LIFE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LUKE LAIDLAW OWNER/DIRECTOR (PRESIDENT)
(320) 295-2460
Entity
Organization
Contact information
Practice address
1187 BLACKHAWK DR SW, HUTCHINSON, MN 55350
(952) 215-4616
(952) 974-7851
Mailing address
1187 BLACKHAWK DR SW, HUTCHINSON, MN 55350
(952) 215-4616
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
MN
Other
Enumeration date
05/29/2013
Last updated
07/06/2018
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