| NPI | 1881387504 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHEN MICHAEL DELISI President 612-699-7778 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry |
| Additional Taxonomies | 207QA0401X Family Medicine, Addiction Medicine |
| 2083A0300X Preventive Medicine, Addiction Medicine | |
| 2084A0401X Psychiatry & Neurology, Addiction Medicine | |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry | |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2023-05-30 |
| Last Update Date | 2023-05-30 |