MEDICARE: LIONHEART WELLNESS AND RECOVERY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	324500000X	Substance Abuse Rehabilitation Facility
2	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)
3	261QR0405X	Substance Use Disorder Rehabilitation Clinic/Center

General Provider Information

NPI Number	:	1104606607
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LIONHEART WELLNESS AND RECOVERY

Provider Business Mailing Address
First Line	:	590 BOHLKEN DR
Second Line	:
City	:	HASTINGS
State	:	MN
Zip	:	55033-3803
Country	:	US
Telephone Number	:	651-456-8411
Fax Number	:

Provider Business Practice Location Address
First Line	:	1112 HIGHWAY 55 STE 101
Second Line	:
City	:	HASTINGS
State	:	MN
Zip	:	55033-2373
Country	:	US
Telephone Number	:	651-456-8411
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	TIFFANY NEUHARTH
Credential	:	LADC
Telephone Number	:	651-417-1614

Provider Enumeration Date	:	10/02/2023
Last Update Date	:	06/23/2026

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Directions to “LIONHEART WELLNESS AND RECOVERY ” Practice Location

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