Organization
THE WAYSIDE HOUSE, INC
Active
Organization
THE WAYSIDE HOUSE, INC
Active
Other names
Wayside Recovery Center, Wayside Recovery
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER WILSON (BILLING MANAGER)
(952) 405-7649
Entity
Organization
Contact information
Practice address
3705 PARK CENTER BLVD, SAINT LOUIS PARK, MN 55416-2504
(952) 926-5626
(952) 926-9713
Mailing address
1600 UNIVERSITY AVE W STE 300, SAINT PAUL, MN 55104-3800
(651) 242-5540
(651) 209-6341
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
802632-1-CDT
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
389255700
—
MN
Enumeration date
10/02/2006
Last updated
11/12/2025
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