National Provider Identifier Database

WILD RIVER SERVICES INC
Substance Abuse Disorder Rehabilitation Facility

A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances.


Contact Information

WILD RIVER SERVICES INC
1394 JACKSON ST
SAINT PAUL, MN55117
Phone: 651-558-9522
Fax:
Website:
Specialty Taxonomy Code
* Substance Abuse Disorder Rehabilitation Facility 324500000X

* Indicates primary specialty

NPI Profile & details for WILD RIVER SERVICES INC

NPI Number 1467961193
Legal business name
LBN
WILD RIVER SERVICES INC
Authorized official COLIN FAULKNER - (EXECUTIVE DIRECTOR)
Entity Organization
Organization subpart Yes
Enumeration date 09/26/2017
Last updated 07/10/2018 - About 8 years ago
Sole proprietor1 Not specified
Identifiers n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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