Provider Demographics
NPI:1548091960
Name:LIFEQUEST
Entity type:Organization
Organization Name:LIFEQUEST
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/LICSW
Authorized Official - Prefix:
Authorized Official - First Name:BEKAH
Authorized Official - Middle Name:
Authorized Official - Last Name:SALITERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:651-263-0004
Mailing Address - Street 1:15798 LINNET ST NW
Mailing Address - Street 2:
Mailing Address - City:ANDOVER
Mailing Address - State:MN
Mailing Address - Zip Code:55304-2791
Mailing Address - Country:US
Mailing Address - Phone:651-263-0004
Mailing Address - Fax:
Practice Address - Street 1:15798 LINNET ST NW
Practice Address - Street 2:
Practice Address - City:ANDOVER
Practice Address - State:MN
Practice Address - Zip Code:55304-2791
Practice Address - Country:US
Practice Address - Phone:651-263-0004
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-08
Last Update Date:2024-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty