=====================================================
General NPI Number Information
=====================================================
NPI Number | 1144119108
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | GREATEST PSYCHIATRY AND WELLNESS LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/02/2025
-----------------------------------------------------
Last Update Date | 07/09/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 5700 COLFAX AVE N
-----------------------------------------------------
City | BROOKLYN CENTER
-----------------------------------------------------
State | MN
-----------------------------------------------------
Zip | 55430-2760
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 763-957-2560
-----------------------------------------------------
Fax | 612-677-3048
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 5700 COLFAX AVE N
-----------------------------------------------------
City | BROOKLYN CENTER
-----------------------------------------------------
State | MN
-----------------------------------------------------
Zip | 55430-2760
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 763-957-2560
-----------------------------------------------------
Fax | 612-677-3048
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CNP, PMHNP-BC
-----------------------------------------------------
Name | DR. ELIJAH YARPAH ZARDYU YARPAH
-----------------------------------------------------
Credential | PHD
-----------------------------------------------------
Telephone | 763-269-3872
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QM0850X
-----------------------------------------------------
Taxonomy Name | Adult Mental Health Clinic/Center
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 261QM0855X
-----------------------------------------------------
Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------