Organization
WILLOW BRIDGE RECOVERY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHELE A BUER (DIRECTOR)
(320) 357-3466
Entity
Organization
Contact information
Practice address
17 2ND ST N, LONG PRAIRIE, MN 56347-1117
(320) 357-3466
(320) 357-3468
Mailing address
PO BOX 56, LONG PRAIRIE, MN 56347-0056
(320) 357-3466
(320) 357-3468
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
251B00000X
Case Management Agency
—
—
251S00000X
Community/Behavioral Health Agency
—
—
261Q00000X
Clinic/Center
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
—
—
324500000X
Substance Abuse Rehabilitation Facility
—
—
3245S0500X
Children's Substance Abuse Rehabilitation Facility
1039454-1-CRF
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
026491100
CHILDRENS RESIDENTIAL
MN
01
—
1107320
NON RESIDENTIAL SUD TREATMENT PROGRAM
MN
Enumeration date
06/06/2007
Last updated
04/06/2021
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