Healthcare Provider Details
I. General information
NPI: 1407315096
Provider Name (Legal Business Name): NEXUS OF HOPE PSYCHIATRY & MENTAL HEALTH WELLNESS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/14/2019
Last Update Date: 03/11/2025
Certification Date: 03/11/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
14031 BURNHAVEN DR STE 106
BURNSVILLE MN
55337-4474
US
IV. Provider business mailing address
14031 BURNHAVEN DR STE 106
BURNSVILLE MN
55337-4474
US
V. Phone/Fax
- Phone: 952-955-4110
- Fax: 952-955-7482
- Phone: 952-955-4110
- Fax: 952-955-7482
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QM0855X |
| Taxonomy | Adolescent and Children Mental Health Clinic/Center |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QM0850X |
| Taxonomy | Adult Mental Health Clinic/Center |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QR0405X |
| Taxonomy | Substance Use Disorder Rehabilitation Clinic/Center |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363LP0808X |
| Taxonomy | Psychiatric/Mental Health Nurse Practitioner |
| License Number | |
| License Number State | |
| # 5 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QM0801X |
| Taxonomy | Mental Health Clinic/Center (Including Community Mental Health Center) |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
ADEJOKE
ADEDEJI
Title or Position: OWNER
Credential: APRN PMHNP-BC
Phone: 952-955-4110