NPIMap

Organization Active NPI

Avalon Programs, LLC

Doing business as Eosis at Minnetonka

  • Substance Abuse Rehabilitation Facility
  • Minnetonka, MN
National Provider Identifier
1922448620
Registry record updated Feb 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
License
1065949 Issued in MN
Legal business name
AVALON PROGRAMS, LLC
Doing business as
Eosis at Minnetonka
Practice address
11900 Wayzata Blvd
Suite 100
Minnetonka, MN 55305-2031
Phone
(612) 454-2012
NPI assigned
Jun 27, 2013
Last updated
Feb 21, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
AVALON PROGRAMS LLCAs reported in NPPES

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 1065949 MN
Substance Abuse Rehabilitation Facility 324500000X 1065949 MN Primary

Addresses

Primary practice location

11900 Wayzata Blvd
Suite 100
Minnetonka, MN 55305-2031

Mailing address

550 Main St Ste 190
Saint Paul, MN 55112-3271
Phone (612) 454-2046

Other names 1

  • EOSIS AT MINNETONKA Doing business as

National Provider Directory

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

Other organizations with this tax ID 11

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

Locations

11900 Wayzata Blvd
Ste 100
Minnetonka, MN 55305
Phone (612) 454-2012

Practitioners & affiliated clinicians

Practitioners 2

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": "1372291200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1740096000000",
    "number": "1922448620",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 MAIN ST STE 190",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551123271",
            "telephone_number": "612-454-2046",
            "fax_number": "952-679-5471"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11900 WAYZATA BLVD",
            "address_2": "SUITE 100",
            "city": "MINNETONKA",
            "state": "MN",
            "postal_code": "553052031",
            "telephone_number": "612-454-2012"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AVALON PROGRAMS, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "AVALON PROGRAMS LLC",
        "enumeration_date": "2013-06-27",
        "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": "1065949",
            "primary": false
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "MN",
            "license": "1065949",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "EOSIS AT MINNETONKA",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Minnetonka, 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.