Provider Demographics
NPI:1609286368
Name:LOVE THE JOURNEY INC
Entity Type:Organization
Organization Name:LOVE THE JOURNEY INC
Other - Org Name:LOVE THE JOURNEY LLC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LORI
Authorized Official - Middle Name:KAY
Authorized Official - Last Name:PETERSEN
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:320-679-6964
Mailing Address - Street 1:23 PINE ST N
Mailing Address - Street 2:
Mailing Address - City:MORA
Mailing Address - State:MN
Mailing Address - Zip Code:55051
Mailing Address - Country:US
Mailing Address - Phone:320-679-6964
Mailing Address - Fax:320-679-8183
Practice Address - Street 1:23 PINE ST N
Practice Address - Street 2:
Practice Address - City:MORA
Practice Address - State:MN
Practice Address - Zip Code:55051
Practice Address - Country:US
Practice Address - Phone:320-679-6964
Practice Address - Fax:320-679-8183
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-04
Last Update Date:2019-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)