CANVAS HEALTH INC. NPI 1104993302

NPI Information

NPI: 1104993302
Provider Name: CANVAS HEALTH, INC.

Former Legal Business Name: HUMAN SERVICES, INC. IN WASHINGTON COUNTY

Classification: Counselor - 101YA0400X
Entity Type: Organization

Specialization: Addiction (Substance Use Disorder)

Address:
8451 E POINT DOUGLAS RD S
COTTAGE GROVE, MN
ZIP 55016
Phone: (651) 458-4116
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CANVAS HEALTH, INC. is an addiction (substance use disorder) counselor in Cottage Grove, MN. CANVAS HEALTH, INC. NPI is 1104993302. The provider is registered as an organization entity type and is a multiple single specialty group.
The provider Former Legal Business Name Is Human Services, Inc. In Washington County.

The provider's business location address is:

8451 E POINT DOUGLAS RD S
COTTAGE GROVE, MN
ZIP 55016-331
Phone: (651) 458-4116
Fax: (651) 458-5632

The provider's authorized official is Matthew M. Eastwood .
The authorized official title is Coo and has the following contact phone number (651) 777-5222.

The enumeration date for this NPI number is 11/30/2006 and was last updated on 2/1/2012.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	101YA0400X	Counselor	Addiction (Substance Use Disorder)	801109	MINNESOTA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	353302600	MEDICAID	MINNESOTA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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