Provider Demographics
NPI:1922051325
Name:CANVAS HEALTH, INC.
Entity Type:Organization
Organization Name:CANVAS HEALTH, INC.
Other - Org Name:HUMAN SERVICES, INC IN WASHINGTON COUNTY
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:KHU
Authorized Official - Middle Name:
Authorized Official - Last Name:THAO
Authorized Official - Suffix:
Authorized Official - Credentials:MSW, PSYD, LICSW, LP
Authorized Official - Phone:651-251-5042
Mailing Address - Street 1:7066 STILLWATER BLVD N
Mailing Address - Street 2:
Mailing Address - City:OAKDALE
Mailing Address - State:MN
Mailing Address - Zip Code:55128-3937
Mailing Address - Country:US
Mailing Address - Phone:651-777-5222
Mailing Address - Fax:651-251-5111
Practice Address - Street 1:7066 STILLWATER BLVD N
Practice Address - Street 2:
Practice Address - City:OAKDALE
Practice Address - State:MN
Practice Address - Zip Code:55128-3937
Practice Address - Country:US
Practice Address - Phone:651-777-5222
Practice Address - Fax:651-251-5111
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-18
Last Update Date:2023-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN56706HUOtherBLUE CROSS BLUE SHIELD
MN313930OtherVALUE OPTIONS
MN8461062OtherUNITED BEHAVIORAL HEALTH
MN106221OtherPMAP U-CARE
MN1029858OtherPREFERRED ONE
MN7948557000Medicaid
MN56706HUOtherBLUE CROSS BLUE SHIELD