Healthcare Provider Details

I. General information

NPI: 1760514699
Provider Name (Legal Business Name): WENDEN RECOVERY SERVICES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/09/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

69 LAFAYETTE ST
WINONA MN
55987-3453
US

IV. Provider business mailing address

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

V. Phone/Fax

Practice location:
  • Phone: 507-454-2839
  • Fax: 507-454-5864
Mailing address:
  • Phone: 651-385-0600
  • Fax: 651-388-2128

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