Organization
RIVER OF LIFE SERVICES LLC
Active
Other names
River of Life Services
Organization subpart
No
Provider details
NPI number
Authorized official
DR. HAYDEN DONALDSON SEVERIN MD (ADDICTIONOLOGY/ASAM CERTIFIED)
(952) 548-9344
Entity
Organization
Contact information
Practice address
6200 EXCELSIOR BLVD, #202, ST LOUIS PARK, MN 55416-2730
(952) 548-9344
(952) 548-9344
Mailing address
6200 EXCELSIOR BLVD, #202, ST LOUIS PARK, MN 55416-2730
(952) 548-9344
(952) 548-9344
Taxonomy
Speciality
Code
Description
License number
State
207RA0401X
Addiction Medicine (Internal Medicine) Physician
Primary
45852
MN
Other
Enumeration date
11/08/2007
Last updated
11/08/2007
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