| NPI | 1861884579 |
|---|---|
| Doing Business As | WAYSIDE WELLNESS CENTER |
| Entity Type | Organization |
| Authorized Contact | JENNIFER WILSON Billing Manager 952-405-7649 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2015-03-04 |
| Last Update Date | 2025-11-12 |