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Organization

WILD RIVER SERVICES

Active
Other names
The Heights University
Organization subpart
No

Provider details

NPI number
Authorized official
COLIN KELLY FAULKNER (EXECUTIVE DIRECTOR)
(651) 558-9522
Entity
Organization

Contact information

Practice address
1246 UNIVERSITY AVE W STE 101, SAINT PAUL, MN 55104-4125
(651) 558-9522
Mailing address
1246 UNIVERSITY AVE W STE 101, SAINT PAUL, MN 55104-4125
(651) 558-9522

Taxonomy

Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
1080800
MN
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
1084328
MN

Other

Enumeration date
03/11/2016
Last updated
01/20/2017
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