Organization
AMHERST H. WILDER FOUNDATION
Active
Other names
Wilder Adult Day Health
Organization subpart
No
Provider details
NPI number
Authorized official
LENI G WILCOX (DIVISION DIRECTOR, CSE)
(651) 280-2500
Entity
Organization
Contact information
Practice address
753 7TH ST E, SAINT PAUL, MN 55106-5025
(651) 280-2500
Mailing address
650 MARSHALL AVE, SAINT PAUL, MN 55104-6644
(651) 280-2500
(651) 224-6906
Taxonomy
Speciality
Code
Description
License number
State
261QA0600X
Adult Day Care Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
369223000
MEDICAL ASSISTANCE
MN
Enumeration date
11/28/2006
Last updated
05/27/2010
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