WATERSHED BEHAVIORAL HEALTH; NPI #1669285524

Contact Information

WATERSHED BEHAVIORAL HEALTH

2429 UNIVERSITY AVE W
SAINT PAUL, MN 55114-1541

Phone: 612-703-9413
Fax:
Website:

	Specialty	Taxonomy Code	Specialty Code	Provider Type
	Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)	261QR0401X	B4[14]	Comprehensive Outpatient Rehabilitation Facility

Indicates primary specialty

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NPI Profile & details for WATERSHED BEHAVIORAL HEALTH

NPI Number	`1669285524`
LBN Legal business name	WATERSHED BEHAVIORAL HEALTH
Authorized official	BISHAR YUSUF - (OWNER)
Entity	Organization
Organization subpart ¹	No
Enumeration date	01/27/2025
Last updated	01/27/2025 - More than a year ago
Identifiers	n/a

¹ Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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