| Organization Name: | RECOVERY PARTNERS, PC AT CENTER CITY |
| NPI Number: | 1295194819 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MARVIN SEPPALA (CHIEF MEDICAL OFFICER) |
| Mailing Address: | 15251 Pleasant Valley Rd Center City |
| State: | MN US |
| Postal Code: | 550129640 |
| Phone Number: | 6512134286 |
| Fax Number: | 6512134543 |
| NPI Enumeration Date: | 02/11/2016 |
| NPI Last Update Date: | 02/11/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TA0400X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |