Organization
AMHERST H. WILDER FOUNDATION
Active
Other names
Wilder Homemaker Services
Organization subpart
No
Provider details
NPI number
Authorized official
CRAIG BINGER (VICE PRESIDENT ADMINISTRATION)
(651) 642-4000
Entity
Organization
Contact information
Practice address
650 MARSHALL AVE, SAINT PAUL, MN 55104
(651) 290-8666
Mailing address
650 MARSHALL AVE, SAINT PAUL, MN 55104
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
767022200
MEDICAL ASSISTANCE
MN
Enumeration date
12/04/2006
Last updated
05/04/2010
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