New Beginings at Waverly, LLC

Organization Active NPI Substance Abuse Rehabilitation Facility · Waverly, MN

NPI 1003914656 · NPPES record last updated Aug 22, 2020

Key facts

NPI
1003914656
Entity type
Organization (NPI type 2)
Primary specialty
Substance Abuse Rehabilitation Facility 324500000X
License
1003743-1-CDT (MN)
Legal business name
NEW BEGININGS AT WAVERLY, LLC
Practice address
109 N Shore Dr
Waverly, MN 55390-5517
Phone
(763) 658-5800
Fax
(763) 658-1746
NPI assigned
Sep 20, 2006
Organization subpart
No

Authorized official

Name
Mrs. Brenda Griffin
Title
Controller
Phone
(763) 658-5222

Corporate family (same tax ID) 1

Organizations that report the same tax identification number in the National Provider Directory.

National Provider Directory

Tax ID family
New Beginings at Waverly LLC (2 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Abuse Rehabilitation Facility 324500000X 1003743-1-CDT MN Yes

Addresses

Primary practice location

109 N Shore Dr
Waverly, MN 55390-5517

Mailing address

109 N Shore Dr
Waverly, MN 55390-5517
Phone (763) 658-5800

Other providers in Waverly, MN

All providers in Waverly, MN · Substance Abuse Rehabilitation Facility in Minnesota

Sources for this page

Verify at the official NPI Registry.