Healthcare Provider Details

I. General information

NPI: 1447381520
Provider Name (Legal Business Name): WENDEN RECOVERY SERVICES OF WABASHA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/08/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

218 MAIN ST W
WABASHA MN
55981-1239
US

IV. Provider business mailing address

217 PLUM ST SUITE 220
RED WING MN
55066-2351
US

V. Phone/Fax

Practice location:
  • Phone: 651-565-5400
  • Fax: 651-565-5404
Mailing address:
  • Phone: 651-388-2090
  • Fax: 651-388-2129

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State

VIII. Authorized Official

Name: MR. ADAM GARCIA
Title or Position: OWNER
Credential: LADC
Phone: 651-385-0600