The Wayside House, Inc

Primary specialty

Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X

License

802632-1-CDT Issued in MN

Legal business name

THE WAYSIDE HOUSE, INC

Doing business as

Wayside Recovery
Wayside Recovery Center

Practice address

3705 Park Center Blvd
Saint Louis Park, MN 55416-2504

Phone

(952) 926-5626

Fax

(952) 926-9713

NPI assigned

Oct 2, 2006

Last updated

Nov 12, 2025By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Jennifer Wilson

Title

Billing Manager

Phone

(952) 405-7649

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 2

• Wayside Recovery Doing business as
• Wayside Recovery Center Doing business as

Tax ID family

Wayside House Inc3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

• The Wayside House, Inc.

  dba Wayside Wellness Center

  • Substance Abuse Rehabilitation Facility
  • Saint Paul, MN
  • NPI 1861884579
  NPD tax ID
• The Wayside House, Inc.

  dba Wayside Family Treatment Center

  • Substance Abuse Rehabilitation Facility
  • Minneapolis, MN
  • NPI 1932413887
  NPD tax ID

Locations

Subparts reporting this organization as parent 2

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• The Wayside House, Inc.

  dba Wayside Wellness Center

  • Substance Abuse Rehabilitation Facility
  • Saint Paul, MN
  • NPI 1861884579
  NPPES parent name
• The Wayside House, Inc.

  dba Wayside Family Treatment Center

  • Substance Abuse Rehabilitation Facility
  • Minneapolis, MN
  • NPI 1932413887
  NPPES parent name

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Heather Anderson, MPS, LADC

  • Mental Health Counselor
  • Minneapolis, MN
  • NPI 1558827691
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1762905600000",
    "number": "1235223652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 UNIVERSITY AVE W STE 300",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551043800",
            "telephone_number": "651-242-5540",
            "fax_number": "651-209-6341"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3705 PARK CENTER BLVD",
            "city": "SAINT LOUIS PARK",
            "state": "MN",
            "postal_code": "554162504",
            "telephone_number": "952-926-5626",
            "fax_number": "952-926-9713"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE WAYSIDE HOUSE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-02",
        "last_updated": "2025-11-12",
        "certification_date": "2025-11-12",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "952-405-7649"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "MN",
            "license": "802632-1-CDT",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "389255700",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wayside Recovery",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Wayside Recovery Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Substance Abuse Rehabilitation Facility in St Louis Park, MN
• Providers in St Louis Park, MN by specialty
• Substance Abuse Rehabilitation Facility in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.