NPI 1134630734

C10202017363071

Organisation Substance Abuse Rehabilitation Facility Waverly, MN

Practice location

Address: 109 N Shore Dr, Waverly, MN 55390
Phone: (763) 658-5800
Fax: (763) 658-4128
Mailing address: C/O Meridian Behavioral Health #190 550 Main Street, New Brighton, MN 55112

Authorised official

Name: Lewis P Zeidner
Title: Ceo
Phone: (763) 245-8278

Registered specialties

Substance Abuse Rehabilitation Facility Primary

Residential Treatment Facilities Taxonomy 324500000X

Other Substance Abuse Rehabilitation Facility providers in Minnesota →

Registry record

NPI: 1134630734
Entity type: Organization
NPI issued: 23 Oct 2017
Record last updated: 21 Feb 2025

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.