| Southdale Addiction Clinic | |
|
2304 Wyoming Ct Sartell MN 56377-4562 | |
| (320) 200-9547 | |
| Not Available |
| Full Name | Southdale Addiction Clinic |
|---|---|
| Speciality | Clinic/center |
| Location | 2304 Wyoming Ct, Sartell, Minnesota |
| Authorized Official Name and Position | Cody W Wendlandt (MEDICAL DIRECTOR) |
| Authorized Official Contact | 3202009547 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Southdale Addiction Clinic 2304 Wyoming Ct Sartell MN 56377-4562 Ph: (320) 200-9547 | Southdale Addiction Clinic 2304 Wyoming Ct Sartell MN 56377-4562 Ph: (320) 200-9547 |
| NPI Number | 1154839660 |
|---|---|
| Provider Enumeration Date | 01/18/2018 |
| Last Update Date | 06/16/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154839660 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
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