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General NPI Number Information
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NPI Number | 1689580318
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Entity Type | Organization
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Legal Business Name | WEST RIVER RECOVERY PLLC
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Dates
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Enumeration Date | 08/21/2026
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Last Update Date | 08/21/2026
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Provider Practice Location Address
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Address Line | 123 MAIN ST. #7
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City | CARSON
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State | ND
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Zip | 58529
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Country | US
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Telephone | 701-920-8379
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Fax |
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Provider Business Mailing Address
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Address Line | 410 IDAHO ST N
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City | CARSON
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State | ND
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Zip | 58529-4032
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Country | US
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Telephone | 701-920-8379
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Fax |
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Authorized Official
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Title or Position | LAC/RCS/OWNER
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Name | SHANNON WANGSVICK
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Credential | BS/LAC/RCS
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Telephone | 701-920-8379
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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