Organization Name: | RIVER VALLEY BEHAVIORAL HEALTH & WELLNESS CENTER, LLC |
NPI Number: | 1316197148 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | KRISTIN LYNN FURAN-KRIESEL (PSYCHOLOGIST/CFO) |
Mailing Address: | 8600 Eagle Creek Pkwy Savage |
State: | MN US |
Postal Code: | 553781284 |
Phone Number: | 9522203268 |
Fax Number: | |
NPI Enumeration Date: | 09/29/2008 |
NPI Last Update Date: | 09/29/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC0700X |
License Number: | LP4664 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MN |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: |