Provider Demographics
NPI:1093521973
Name:LEVEL UP FITNESS & RECOVERY LLC
Entity type:Organization
Organization Name:LEVEL UP FITNESS & RECOVERY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CERTIFIED PEER RECOVERY SPECIALIST
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:MATTHEW
Authorized Official - Last Name:MUNSON
Authorized Official - Suffix:
Authorized Official - Credentials:CPRS-R
Authorized Official - Phone:952-288-9900
Mailing Address - Street 1:1055 STOUGHTON AVE
Mailing Address - Street 2:
Mailing Address - City:CHASKA
Mailing Address - State:MN
Mailing Address - Zip Code:55318-2149
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:14400 MARTIN DR
Practice Address - Street 2:
Practice Address - City:EDEN PRAIRIE
Practice Address - State:MN
Practice Address - Zip Code:55344-2031
Practice Address - Country:US
Practice Address - Phone:952-444-9576
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-05
Last Update Date:2024-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes175T00000XOther Service ProvidersPeer SpecialistGroup - Multi-Specialty