Provider Demographics
NPI:1881643641
Name:CNS MANAGED HEALTH CARE, INC.
Entity Type:Organization
Organization Name:CNS MANAGED HEALTH CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:ALICE
Authorized Official - Middle Name:
Authorized Official - Last Name:SYVERSON
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:507-289-2411
Mailing Address - Street 1:1133B 7TH AVE SW
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:MN
Mailing Address - Zip Code:55902-6388
Mailing Address - Country:US
Mailing Address - Phone:507-289-2411
Mailing Address - Fax:507-529-0360
Practice Address - Street 1:1133B 7TH AVE SW
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:MN
Practice Address - Zip Code:55902-6388
Practice Address - Country:US
Practice Address - Phone:507-289-2411
Practice Address - Fax:507-529-0360
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-09
Last Update Date:2008-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN330402251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN8C00CNOtherBCBS
MN248098Medicare Oscar/Certification