Organization
AVIVO
Active
Other names
Recovery Resource Center
Organization subpart
No
Provider details
NPI number
Authorized official
KELLY MATTER (CEO)
(612) 752-8052
Entity
Organization
Contact information
Practice address
1900 CHICAGO AVE, MINNEAPOLIS, MN 55404-1903
(612) 752-8000
(612) 752-8001
Mailing address
1900 CHICAGO AVE, MINNEAPOLIS, MN 55404-1903
(612) 752-8000
(612) 752-8001
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
251S00000X
Community/Behavioral Health Agency
801609-2-CDT
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
859255100
—
MN
Enumeration date
01/23/2007
Last updated
12/11/2023
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