Wild River Services INC
NPI #1962013847 in Saint Paul, Minnesota
Provider Information
- NPI Number
- 1962013847
- Entity Type
- Organization
- Organization Name
- Wild River Services INC
- Primary Specialty
- Clinic/Center - Adult Day Care
- Enumeration Date
- Aug 13, 2020
- Last Updated
- Aug 13, 2020
Practice Location
- Address
- 1394 JACKSON ST STE 220
- City
- Saint Paul
- State
- Minnesota
- ZIP Code
- 55117-4631
- Phone
- (651) 558-9522
Authorized Official
- Name
- COLIN KELLY FAULKNER
- Title
- EXECUTIVE DIRECTOR
- Phone
- (651) 558-9522
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center - Adult Day Care — Adult Day Care |
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