Provider Demographics
NPI:1679604730
Name:WENDEN RECOVERY SERVICES, INC
Entity Type:Organization
Organization Name:WENDEN RECOVERY SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ADAM
Authorized Official - Middle Name:
Authorized Official - Last Name:GARCIA
Authorized Official - Suffix:
Authorized Official - Credentials:LADC
Authorized Official - Phone:651-385-0600
Mailing Address - Street 1:217 PLUM ST
Mailing Address - Street 2:ARMORY CENTER, SUITE 220
Mailing Address - City:RED WING
Mailing Address - State:MN
Mailing Address - Zip Code:55066-2351
Mailing Address - Country:US
Mailing Address - Phone:651-385-0600
Mailing Address - Fax:651-388-2129
Practice Address - Street 1:217 PLUM ST
Practice Address - Street 2:ARMORY CENTER, SUITE 220
Practice Address - City:RED WING
Practice Address - State:MN
Practice Address - Zip Code:55066-2351
Practice Address - Country:US
Practice Address - Phone:651-385-0600
Practice Address - Fax:651-388-2129
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN173157OtherUCARE PROVIDER #
MN5289116OtherUBH PROVIDER #
MN91185OtherHEALTHPARTNERS PROVIDER #
MN1032924OtherPREFERRED ONE PROVIDER #
MN1H21WEOtherBLUE CROSS PROVIDER #