FIVE STAR RECOVERY CENTER NPI 1235237199

NPI Information

NPI: 1235237199
Provider Name: FIVE STAR RECOVERY CENTER
Classification: Counselor - 101YA0400X
Entity Type: Organization

Specialization: Addiction (Substance Use Disorder)

Address:
102 E 2ND ST
SUITE 110B
CHASKA, MN
ZIP 55318
Phone: (952) 448-6557
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FIVE STAR RECOVERY CENTER is an addiction (substance use disorder) counselor in Chaska, MN. FIVE STAR RECOVERY CENTER NPI is 1235237199. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

102 E 2ND ST
SUITE 110B
CHASKA, MN
ZIP 55318-966
Phone: (952) 448-6557
Fax: (952) 448-6047

The provider's authorized official is Jason David Vanderscoff .
The authorized official title is Managing Director and has the following contact phone number (952) 448-6557.

The enumeration date for this NPI number is 9/21/2006 and was last updated on 11/25/2008.

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)			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	8409617	OTHER	MINNESOTA	UBH / MEDICA
2	82387	OTHER	MINNESOTA	HEALTH PARTNERS
3	4C35FI	OTHER		BLUE CROSS BLUE SHIELD MN
4	724455000	MEDICAID	MINNESOTA
5	1031769	OTHER	MINNESOTA	PREF ONE

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

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