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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