WILLOW BRIDGE RECOVERY LLC NPI 1386847515

NPI Information

NPI: 1386847515
Provider Name: WILLOW BRIDGE RECOVERY, LLC
Classification: Clinic/Center - 261QR0405X
Entity Type: Organization

Specialization: Rehabilitation, Substance Use Disorder

Address:
17 2ND ST N
LONG PRAIRIE, MN
ZIP 56347
Phone: (320) 357-3466
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WILLOW BRIDGE RECOVERY, LLC is a rehabilitation and substance use disorder clinic center in Long Prairie, MN. WILLOW BRIDGE RECOVERY, LLC NPI is 1386847515. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

17 2ND ST N
LONG PRAIRIE, MN
ZIP 56347-117
Phone: (320) 357-3466
Fax: (320) 357-3468

The provider's authorized official is Michele A Buer .
The authorized official title is Director and has the following contact phone number (320) 357-3466.

The enumeration date for this NPI number is 6/6/2007 and was last updated on 4/6/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	101YA0400X	Counselor	Addiction (Substance Use Disorder)			No
2	251B00000X	Case Management				No
3	261Q00000X	Clinic/Center				No
4	261QR0405X	Clinic/Center	Rehabilitation, Substance Use Disorder			Yes
5	324500000X	Substance Abuse Rehabilitation Facility				No
6	3245S0500X	Substance Abuse Rehabilitation Facility	Substance Abuse Treatment, Children	1039454-1-CRF	MINNESOTA	No
7	251S00000X	Community/Behavioral Health				No

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	1107320	OTHER	MINNESOTA	NON RESIDENTIAL SUD TREATMENT PROGRAM
2	026491100	OTHER	MINNESOTA	CHILDRENS RESIDENTIAL

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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