Healthcare Provider Details

I. General information

NPI: 1790609527
Provider Name (Legal Business Name): STEVEN EDWIN HRUBY LADC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/05/2026
Last Update Date: 08/05/2026
Certification Date: 08/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

114 N HOLCOMBE AVE STE 140
LITCHFIELD MN
55355-2348
US

IV. Provider business mailing address

114 N HOLCOMBE AVE STE 140
LITCHFIELD MN
55355-2348
US

V. Phone/Fax

Practice location:
  • Phone: 320-442-1018
  • Fax: 320-693-2435
Mailing address:
  • Phone: 320-442-1018
  • Fax: 320-693-2435

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number303077
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: