Organization · Type 2 NPI
Club Recovery LLC
Substance Use Disorder Rehabilitation Clinic/Center · Edina, MN
NPI number
1023032703
Active
Practice location
7701 York Ave S, Ste 350
Edina, MN 55435
Fax (952) 926-6791
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Substance Use Disorder Rehabilitation Clinic/Center Primary | 261QR0405X | 10043993CDT (MN) |
Substance Use Disorder Rehabilitation Clinic/Center: Definition to come...
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- Bradley M. Doeden, MDSpecialist Edina, MN NPI 1780644047
- J Jeffrey Ruegemer, MDSpecialist Edina, MN NPI 1326007709
- Jasmin Grace Valera Ramirez, RD LD CDEMetabolic Nutrition Registered Dietitian Edina, MN NPI 1588628135
- Lisa Kae Feese, RN CDE FNPNurse Practitioner Edina, MN NPI 1033173620
- Rebecca Suzanne Mattison, MDSpecialist Edina, MN NPI 1093775736
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- Wayne Frederick Leebaw, MDSpecialist Edina, MN NPI 1033178405
About NPI 1023032703
Club Recovery LLC's National Provider Identifier is 1023032703, issued on Jul 27, 2006. The primary taxonomy on file is Substance Use Disorder Rehabilitation Clinic/Center (261QR0405X), and the practice location is in Edina, MN. The record was last updated on Aug 12, 2026.