Provider Demographics
NPI:1033633953
Name:PRAESTAN HEALTH, LLC
Entity Type:Organization
Organization Name:PRAESTAN HEALTH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:LEONARD
Authorized Official - Middle Name:READ
Authorized Official - Last Name:SULIK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:612-284-3220
Mailing Address - Street 1:3415 SAINT PAUL AVE
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55416-4342
Mailing Address - Country:US
Mailing Address - Phone:612-284-3220
Mailing Address - Fax:
Practice Address - Street 1:3415 SAINT PAUL AVE
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55416-4342
Practice Address - Country:US
Practice Address - Phone:612-284-3220
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-02
Last Update Date:2020-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty