Provider Demographics
NPI:1548341688
Name:COMMUNITY DRUG & ALCOHOL SERVICES INC
Entity type:Organization
Organization Name:COMMUNITY DRUG & ALCOHOL SERVICES INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF FINANCE
Authorized Official - Prefix:
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:PATCHE
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:952-564-3000
Mailing Address - Street 1:151 W BURNSVILLE PKWY STE 100
Mailing Address - Street 2:
Mailing Address - City:BURNSVILLE
Mailing Address - State:MN
Mailing Address - Zip Code:55337-2525
Mailing Address - Country:US
Mailing Address - Phone:952-564-3000
Mailing Address - Fax:651-925-0256
Practice Address - Street 1:151 W BURNSVILLE PKWY STE 100
Practice Address - Street 2:
Practice Address - City:BURNSVILLE
Practice Address - State:MN
Practice Address - Zip Code:55337-2525
Practice Address - Country:US
Practice Address - Phone:952-564-3000
Practice Address - Fax:651-925-0256
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-17
Last Update Date:2018-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
104100000X
MN251S00000X, 261Q00000X, 261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty
No251S00000XAgenciesCommunity/Behavioral Health
No261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN165166800Medicaid
MN943127101Medicaid
MN071688000Medicaid
MN060113009OtherMETROPOLITAN HEALTH PLAN
MN070726006OtherMAGELLAN
MN87726OtherUNITED HEALTH CARE
MN131913OtherUCARE
MN98D69COOtherBCBS
MN1023425OtherPREFERRED ONE BHP
MN67161OtherHEALTH PARTNERS