Organization
WILD RIVER SERVICES
Active
Organization
WILD RIVER SERVICES
Active
Other names
The Heights
Organization subpart
No
Provider details
NPI number
Authorized official
COLIN KELLY FAULKNER II (EXECUTIVE DIRECTOR)
(651) 558-9522
Entity
Organization
Contact information
Practice address
796 CAPITOL HTS, SAINT PAUL, MN 55103-1852
(651) 558-9522
Mailing address
1246 UNIVERSITY AVE W, SUITE 101, SAINT PAUL, MN 55104-4125
(651) 558-9522
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
1084357
MN
324500000X
Substance Abuse Rehabilitation Facility
—
—
Other
Enumeration date
06/23/2014
Last updated
01/20/2017
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