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General NPI Number Information
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NPI Number | 1285353003
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Entity Type | Organization
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Legal Business Name | NEXUS BEHAVIORAL HEALTH LLC
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Dates
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Enumeration Date | 08/24/2022
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Last Update Date | 08/24/2022
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Provider Practice Location Address
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Address Line | 1935 COUNTY ROAD B2 W STE 45
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City | SAINT PAUL
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State | MN
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Zip | 55113-2780
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Country | US
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Telephone | 651-703-1711
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Fax |
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Provider Business Mailing Address
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Address Line | 1935 COUNTY ROAD B2 W STE 45
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City | SAINT PAUL
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State | MN
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Zip | 55113-2780
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MANAGING PARTNER
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Name | ISMAIL TUFA
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Credential |
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Telephone | 651-703-1711
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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License Number |
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License Number State |
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