WILD RECOVERY LLC
NPI 1659245330
Substance Abuse Rehabilitation Facility in Fridley, MN

Active since October 03, 2025
1250 MOORE LAKE DR E STE 210, FRIDLEY, MN 55432(612) 201-2280(612) 465-2096 Get Directions Write a Review

NPPES record last updated: June 23, 2026. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Wild Recovery Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

WILD RECOVERY LLC (NPI 1659245330) is a healthcare organization registered as a substance abuse rehabilitation facility in Fridley, Minnesota and active in the NPI registry since October 2025. The organization lists Tracy Lee/alvin Doerr, Ceo, as its authorized official.

NPPES Registry Identity

NPI1659245330
Entity TypeOrganization
Primary Taxonomy324500000X
Legal Business NameWILD RECOVERY LLC
Location Address1250 MOORE LAKE DR E STE 210Fridley, MN 55432-5135
Mailing Address1250 Moore Lake Dr E Ste 210Fridley, MN 55432-5135 · (612) 201-2280 · Fax (612) 465-2096
Fax(612) 465-2096
Organization SubpartYes
Authorized OfficialTracy Lee/alvin DoerrCeo · (612) 201-2280
Enumeration DateOctober 3, 2025
Last NPPES UpdateJune 23, 2026
NPPES CertifiedJune 23, 2026
NPI 1659245330 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtySubstance Abuse Rehabilitation FacilityResidential Treatment Facilities
Taxonomy Code324500000X
Definition

A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances.

Also ListedCommunity/Behavioral HealthTaxonomy 251S00000X
1250 MOORE LAKE DR E STE 210, Fridley, MN 55432

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Substance Abuse Rehabilitation Facility
1250 MOORE LAKE DR E STE 210
FRIDLEY, MN 55432

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Wild Recovery LLC's NPI number?

The NPI number for Wild Recovery LLC is 1659245330. It was assigned to this organization in the NPPES registry on October 3, 2025.

Where is Wild Recovery LLC located?

Wild Recovery LLC is located at 1250 Moore Lake Dr E Ste 210, Fridley, MN 55432. The listed phone number is (612) 201-2280.

What is Wild Recovery LLC's specialty?

The primary specialty registered for this NPI is Substance Abuse Rehabilitation Facility with taxonomy code 324500000X.

When was this NPI record last updated?

The NPPES record for Wild Recovery LLC was last updated on June 23, 2026. NPI Profile syncs with the weekly NPPES data releases published by CMS.