WAYSIDE HOUSE INC. NPI 1649756040

NPI Information

NPI: 1649756040
Provider Name: WAYSIDE HOUSE, INC.

Doing Business As: WAYSIDE RECOVERY CENTER

Classification: Substance Abuse Rehabilitation Facility - 324500000X
Entity Type: Organization
Address:
1349 JERSEY AVE S
ST. LOUIS PARK, MN
ZIP 55426
Phone: (952) 542-9322
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WAYSIDE HOUSE, INC. is a substance abuse rehabilitation facility in St. Louis Park, MN. The provider is a facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances. WAYSIDE HOUSE, INC. NPI is 1649756040. The provider is registered as an organization entity type.
The provider Is Doing Business As Wayside Recovery Center.

The provider's business location address is:

1349 JERSEY AVE S
ST. LOUIS PARK, MN
ZIP 55426
Phone: (952) 542-9322
Fax: (952) 542-0031

The provider's authorized official is Karina Forrest-perkins .
The authorized official title is Ceo and has the following contact phone number (651) 242-5542.

The enumeration date for this NPI number is 7/18/2018 and was last updated on 7/18/2018.

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	261QM0801X	Clinic/Center	Mental Health (Including Community Mental Health Center)	1092849	MINNESOTA	No
2	324500000X	Substance Abuse Rehabilitation Facility		1092849	MINNESOTA	Yes

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

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