NPIMap

Organization Active NPI

Avalon Programs, LLC

Doing business as Eosis at Eagan

  • Substance Abuse Rehabilitation Facility
  • Eagan, MN
National Provider Identifier
1164556544
Registry record updated Feb 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
Legal business name
AVALON PROGRAMS, LLC
Doing business as
Eosis at Eagan
Practice address
3740 Washington Drive # 165
Eagan, MN 55122
Phone
(651) 454-2833
Fax
(651) 454-2972
NPI assigned
Mar 15, 2007
Last updated
Feb 21, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Lewis P Zeidner, PHD
Title
Ceo
Phone
(763) 245-8278

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YA0400X MN
Substance Abuse Rehabilitation Facility 324500000X MN Primary

Addresses

Primary practice location

3740 Washington Drive # 165
Eagan, MN 55122

Mailing address

3470 Washington Ave Suite 165
Eagan, MN 55122
Phone (612) 326-7600

Other names 1

  • EOSIS AT EAGAN Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Avalon Programs LLC12 organizations share this tax ID, including this one

Other organizations with this tax ID 11

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1173916800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1740096000000",
    "number": "1164556544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3470 WASHINGTON AVE SUITE 165",
            "city": "EAGAN",
            "state": "MN",
            "postal_code": "55122",
            "telephone_number": "612-326-7600",
            "fax_number": "651-631-3231"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3740 WASHINGTON DRIVE # 165",
            "city": "EAGAN",
            "state": "MN",
            "postal_code": "55122",
            "telephone_number": "651-454-2833",
            "fax_number": "651-454-2972"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AVALON PROGRAMS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-15",
        "last_updated": "2025-02-21",
        "status": "A",
        "authorized_official_last_name": "ZEIDNER",
        "authorized_official_first_name": "LEWIS",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "763-245-8278",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MN",
            "license": null,
            "primary": false
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "MN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "EOSIS AT EAGAN",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Eagan, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.