Provider Demographics
NPI:1447755814
Name:BETTER OUTLOOK LLC
Entity Type:Organization
Organization Name:BETTER OUTLOOK LLC
Other - Org Name:BETTER OUTLOOK
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ELVIS
Authorized Official - Middle Name:TAMBI
Authorized Official - Last Name:STARLLONE
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP
Authorized Official - Phone:651-410-7955
Mailing Address - Street 1:625 HAYWARD AVE N
Mailing Address - Street 2:
Mailing Address - City:OAKDALE
Mailing Address - State:MN
Mailing Address - Zip Code:55128-7127
Mailing Address - Country:US
Mailing Address - Phone:651-410-7955
Mailing Address - Fax:
Practice Address - Street 1:625 HAYWARD AVE N
Practice Address - Street 2:
Practice Address - City:OAKDALE
Practice Address - State:MN
Practice Address - Zip Code:55128-7127
Practice Address - Country:US
Practice Address - Phone:651-410-7955
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-28
Last Update Date:2021-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN5270363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty