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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