The Wayside House, Inc

LBN: The Wayside House, Inc
The Wayside House, Inc is an health care organization with primary practice located at 3705 Park Center Blvd , Saint Louis Park MN 55416-2504. The organization recently has only one registered license in Residential Treatment Facilities / Substance Abuse Rehabilitation Facility, which is considered as the primary health care specialty. The Wayside House, Inc can be contacted via phone (952) 926-5626, or through Wilson, Jennifer via phone (952) 405-7649.

Contact Information

Primary practice address
3705 Park Center Blvd Saint Louis Park MN 55416-2504
Phone: (952) 926-5626
Fax: (952) 926-9713
Website:
Map and Directions
Authorized official contact:
Name: Wilson, Jennifer
Phone: (952) 405-7649

Health care specialties

SpecialtyCodeLicense #State
Residential Treatment Facilities / Substance Abuse Rehabilitation Facility 324500000X 802632-1-CDT Minnesota

Profile Details

NPI number 1235223652
LBN Legal business name The Wayside House, Inc
DBA Doing business as
Authorized official Wilson, Jennifer
Entity Organization
Organization subpart 1 No
Enumeration date Oct 2nd, 2006
Last updated Nov 12th, 2025 - about last year

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1235223652 NPPES
Minnesota MEDICAID 389255700

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