LIFE TRANSFORMATIONS (NPI# 1689186587) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1689186587 |
| Entity Type | Organization |
| Organization Name | LIFE TRANSFORMATIONS |
| Practice Address |
227 6th St N Breckenridge MN 56520-1503 |
| Mailing Address |
Po Box 703 Fergus Falls MN 56538-0703 |
| Practice Telephone | 7016408915 |
| Enumeration Date | 2017-10-31 |
| Last Update Date | 2018-06-16 |
| Authorized Official Name | MATA PETESON (OWNER/ADDICTION COUNSELOR) |
| Authorized Official Telephone | 7016408915 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
Behavioral Health & Social Service Providers |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Colorado Business Entities | LIfe Transformations by HIlda, LLC. | 2353 S. Harlan Court, Lakewood, CO 80227 |
| North Carolina Corporations | Life Transformations LLC | 5742 Inman Rd, Greensboro, NC 27410 |
| Oregon Corporations, Companies and Business Names | LIFE TRANSFORMATIONS MISSIONS | 103 Hampton Ln, Pelham, AL 35124 |
| Vermont Business Registrations | LIFE TRANSFORMATIONS, LLC | 85 North Main St., Suite 222, White River Jct, VT 05001 |
| Street Address |
227 6TH ST N |
| City | BRECKENRIDGE |
| State | MN |
| Zip Code | 56520-1503 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962567529 | Wilkin County Family Services | Public Health or Welfare | 227 6th St N, Breckenridge, MN 56520-1503 | 2006-12-26 |
| 1710320890 | Mata Marie Peterson | Counselor | 227 6th St N, Breckenridge, MN 56520-1503 | 2013-04-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831311349 | Carrie Marie Voightman | Occupational Therapist | 1110 Hwy 75, Suite A, Breckenridge, MN 56520 | 2007-05-03 |
| 1063542371 | Jan E Ketterling | Psychologist | 2400 St Francis Drive, Hope Unit St Francis Medical Center, Breckenridge, MN 56520 | 2007-03-06 |
| 1174668081 | Timoth Y John Peterson | General Acute Care Hospital | St. Francis Healthcare Campus, 2400 St. Francis Drive, Breckenridge, MN 56520 | 2007-02-20 |
| 1699859942 | Gerald Dale Brudvik | Dentist | 430 Oak St., Breckenridge, MN 56520 | 2006-10-24 |
| 1881794642 | Pamela Jean Thompson | Social Worker | 415 1/2 Nebraska Ave., Breckenridge, MN 56520 | 2006-09-22 |
| 1588600928 | Robert C Eelkema | Emergency Medicine | 2400 St Francis Dr, Breckenridge, MN 56520 | 2006-06-22 |
| 1639162381 | St. Francis Medical Center | General Acute Care Hospital | 2400 St. Francis Drive, Breckenridge, MN 56520 | 2005-08-29 |
| 1194158899 | Randi Jo Resler | Counselor | 2400 St. Francis Drive, Breckenridge, MN 56520 | 2013-08-16 |
| 1194158006 | Jennifer L Schalekamp | Physical Therapist | 430 5th St N, Breckenridge, MN 56520 | 2013-08-14 |
| 1912220229 | Community Addiction Recovery Enterprises | Clinic/Center | 3850 200th Ave, Breckenridge, MN 56520 | 2010-03-02 |
| Find all providers in zip 56520 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396109211 | Rhonda Carroll | Counselor | 2400 St Francis Dr, Breckenridge, MN 56520-1025 | 2016-04-06 |
| 1194158899 | Randi Jo Resler | Counselor | 2400 St. Francis Drive, Breckenridge, MN 56520 | 2013-08-16 |
| 1710320890 | Mata Marie Peterson | Counselor | 227 6th St N, Breckenridge, MN 56520-1503 | 2013-04-09 |
| 1154521516 | Laurie Jo Ann Kessler | Counselor | 2400 St. Francis Drive, Breckenridge, MN 56520 | 2007-07-23 |
| 1093858565 | Joseph Paul Murray | Counselor | 2400 St Francis Dr, Breckenridge, MN 56520-1025 | 2007-02-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790386456 | Alexandra Lloyd Conroy | Counselor | 3227 Lake Shore Boulevard, Minnetonka, MN 55391 | 2020-11-07 |
| 1134720212 | Rachel Renee Przekwas | Counselor | 216 Center St W Ste 101, Roseau, MN 56751-1494 | 2020-11-04 |
| 1568062461 | Andrew Moe | Counselor | 2118 Blaisdell Ave S., Minneapolis, MN 55404 | 2020-10-29 |
| 1215537477 | Hannah Mae Kidder | Counselor | 1605 Welcome Ave N, Golden Valley, MN 55422-4429 | 2020-10-27 |
| 1649879339 | Jordan Lowe | Counselor | 4615 Grand Ave Ste 300, Duluth, MN 55807-2749 | 2020-10-22 |
| 1417556762 | Jacob R Poppinga | Counselor | 13045 Falcon Dr Ste 7404th, Baxter, MN 56425-4201 | 2020-10-19 |
| 1598362014 | Jeremy Krekula | Counselor | 102 Main St N Ste 100, Stewartville, MN 55976-2608 | 2020-10-07 |
| 1235736786 | Catherine Ann Jaksha | Counselor | 1180 Cushing Cir Apt 217, Saint Paul, MN 55108-5016 | 2020-10-07 |
| 1952908881 | Sutton Outpatient Services, LLC | Counselor | 1700 Livingston Ave Ste 120, West St Paul, MN 55118-5938 | 2020-10-05 |
| 1750998423 | Recovery Alliance Duluth | Counselor | 206 W 4th St Ste 203, Duluth, MN 55806-2659 | 2020-09-28 |
| Find all providers with the same taxonomy | ||||
| City | BRECKENRIDGE |
| Zip Code | 56520 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.