NPIMap

Organization Active NPI

Wild River Services

  • Substance Abuse Rehabilitation Facility
  • Saint Paul, MN
National Provider Identifier
1679988109
Registry record updated Jan 20, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
License
1084357 Issued in MN
Legal business name
WILD RIVER SERVICES
Doing business as
The Heights
Practice address
796 Capitol HTS
Saint Paul, MN 55103-1852
Phone
(651) 558-9522
NPI assigned
Jun 23, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2017

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

Authorized official

Name
Colin Kelly Faulkner IINPI 1881009306
Title
Executive Director
Phone
(651) 558-9522

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Abuse Rehabilitation Facility 324500000X
Substance Abuse Rehabilitation Facility 324500000X 1084357 MN Primary

Addresses

Primary practice location

796 Capitol HTS
Saint Paul, MN 55103-1852

Mailing address

1246 University Ave W
Suite 101
Saint Paul, MN 55104-4125
Phone (651) 558-9522

Other names 1

  • The Heights Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Wild River Services4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

Locations

796 Capitol Hts
Saint Paul, MN 55103
Phone (651) 221-9880

1246 University Ave W
Ste 101
Saint Paul, MN 55104
Phone (651) 558-9522

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1403481600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1484870400000",
    "number": "1679988109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1246 UNIVERSITY AVE W",
            "address_2": "SUITE 101",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551044125",
            "telephone_number": "651-558-9522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "796 CAPITOL HTS",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551031852",
            "telephone_number": "651-558-9522"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILD RIVER SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-06-23",
        "last_updated": "2017-01-20",
        "status": "A",
        "authorized_official_last_name": "FAULKNER",
        "authorized_official_first_name": "COLIN",
        "authorized_official_middle_name": "KELLY",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "651-558-9522",
        "authorized_official_name_suffix": "II"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "MN",
            "license": "1084357",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Heights",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Saint Paul, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2017; 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.