River of Life Services LLC

Primary specialty

Addiction Medicine (Internal Medicine) PhysicianTaxonomy code 207RA0401X

License

45852 Issued in MN

Legal business name

RIVER OF LIFE SERVICES LLC

Doing business as

River of Life Services

Practice address

6200 Excelsior Blvd
#202
St Louis Park, MN 55416-2730

Phone

(952) 548-9344

Fax

(952) 548-9344

NPI assigned

Nov 8, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Hayden Donaldson Severin, MD

Title

Addictionology/Asam Certified

Phone

(952) 548-9344

Specialties & licenses 1

Addresses

Other names 1

• River of Life Services Doing business as

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1194480000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1194480000000",
    "number": "1144400011",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6200 EXCELSIOR BLVD",
            "address_2": "#202",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554162730",
            "telephone_number": "952-548-9344",
            "fax_number": "952-548-9344"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6200 EXCELSIOR BLVD",
            "address_2": "#202",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554162730",
            "telephone_number": "952-548-9344",
            "fax_number": "952-548-9344"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIVER OF LIFE SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-08",
        "last_updated": "2007-11-08",
        "status": "A",
        "authorized_official_last_name": "SEVERIN",
        "authorized_official_first_name": "HAYDEN",
        "authorized_official_middle_name": "DONALDSON",
        "authorized_official_title_or_position": "ADDICTIONOLOGY/ASAM CERTIFIED",
        "authorized_official_telephone_number": "952-548-9344",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RA0401X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Addiction Medicine",
            "state": "MN",
            "license": "45852",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "River of Life Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Clare Marie Riley, BA
• Katie Rose Rinehart
• Jennifer Riss, PHARM.D.
• Kristin Nicole Ritter, M.D.
• Laurie J Ritz
• Kristin Marie Rivers, DMD
• Angelina Rizzo
• Roadway LLC
• Bailey Roberts
• Carol Margaret Roberts

• Addiction Medicine (Internal Medicine) Physician in St Louis Park, MN
• Providers in St Louis Park, MN by specialty
• Addiction Medicine (Internal Medicine) Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.