Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days.
Organization
FIVE STAR RECOVERY CENTER
Active
Organization
FIVE STAR RECOVERY CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JASON DAVID VANDERSCOFF (MANAGING DIRECTOR)
(952) 448-6557
Entity
Organization
Contact information
Practice address
102 E 2ND ST, SUITE 110B, CHASKA, MN 55318-1966
(952) 448-6557
(952) 448-6047
Mailing address
102 E 2ND ST, SUITE 110B, CHASKA, MN 55318-1966
(952) 448-6557
(952) 448-6047
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1031769
PREF ONE
MN
01
—
4C35FI
BLUE CROSS BLUE SHIELD MN
—
05
—
724455000
—
MN
01
—
82387
HEALTH PARTNERS
MN
01
—
8409617
UBH / MEDICA
MN
Enumeration date
09/21/2006
Last updated
11/25/2008
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up