| Canvas Health, Inc. | |
|
121 11th Ave Se Forest Lake MN 55025-1850 | |
| (651) 251-5220 | |
| (651) 251-5279 |
| Full Name | Canvas Health, Inc. |
|---|---|
| Speciality | Counselor - Addiction (substance Use Disorder) |
| Location | 121 11th Ave Se, Forest Lake, Minnesota |
| Authorized Official Name and Position | Matthew M. Eastwood (COO) |
| Authorized Official Contact | 6517775222 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Canvas Health, Inc. 7066 Stillwater Blvd N Oakdale MN 55128-3937 Ph: (651) 777-5222 | Canvas Health, Inc. 121 11th Ave Se Forest Lake MN 55025-1850 Ph: (651) 251-5220 |
| NPI Number | 1528129574 |
|---|---|
| Provider Enumeration Date | 12/13/2006 |
| Last Update Date | 02/01/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528129574 | NPI | - | NPPES |
| 353302600 | Medicaid | MN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | 801109 (Minnesota) | Primary |
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