Provider Demographics
NPI:1760514699
Name:WENDEN RECOVERY SERVICES, INC
Entity Type:Organization
Organization Name:WENDEN RECOVERY SERVICES, INC
Other - Org Name:WENDEN RECOVERY SERIVCES OF WINONA
Other - Org Type:Doing Business As
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:651-388-2128
Practice Address - Street 1:69 LAFAYETTE ST
Practice Address - Street 2:
Practice Address - City:WINONA
Practice Address - State:MN
Practice Address - Zip Code:55987-3453
Practice Address - Country:US
Practice Address - Phone:507-454-2839
Practice Address - Fax:507-454-5864
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-09
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
1032924OtherPREFERRED ONE PROVIDER #
98189OtherHEALTHPARTNERS PROVIDER #
MN3J31WEOtherBLUE CTROSS PROVIDER #
MN173157OtherUCARE PROVIDER #