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LIVING FREE RECOVERY SERVICES, LLC

Addiction Substance Use Disorder

Brooklyn Park, Minnesota

Provider NPI: 1144227430

Organization Information:
Organization Name:  LIVING FREE RECOVERY SERVICES, LLC
Organization is not Subpart
Authorized Official:  TREENA  HAASE  PRESIDENT  763-3157174

Practice Location:
9201 75TH AVENUE NORTH  BROOKLYN PARK, MN 55428 US
Tel: 763-315-7000  Fax: 763-315-7177

Business Mailing Address:
9201 75TH AVENUE NORTH  BROOKLYN PARK, MN 55428 US
Tel: 763-315-7000  Fax: 763-315-7177

Entity Type: Organization

Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
Y101YA0400XBehavioral Health & Social Service Providers
Counselor
Addiction (Substance Use Disorder)
MN830992-2-CDT

Other Provider Identifiers:

IssuerNumberStateType
UBH- ASSESSMENT ONLY8446051MN01
UBH - RELAPSE8442761FM01
BCBS OF MN0C20LIMN01
UBH - ADULT8442759MN01
251922400MN05
UBH - ADOLESCENT8442760MN01
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin







ADDICTION JOBS MN - Page 1



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