Provider Demographics
NPI:1578307708
Name:RELAUNCH PSYCHIATRY SERVICES
Entity type:Organization
Organization Name:RELAUNCH PSYCHIATRY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PMHNP
Authorized Official - Prefix:MISS
Authorized Official - First Name:ABLAVI
Authorized Official - Middle Name:SYLVIA
Authorized Official - Last Name:SABOUTEY
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:612-616-6227
Mailing Address - Street 1:7635 148TH ST W # 240
Mailing Address - Street 2:
Mailing Address - City:APPLE VALLEY
Mailing Address - State:MN
Mailing Address - Zip Code:55124-7800
Mailing Address - Country:US
Mailing Address - Phone:507-237-6468
Mailing Address - Fax:
Practice Address - Street 1:1300 BOLLENBACHER DR STE B
Practice Address - Street 2:
Practice Address - City:NORTHFIELD
Practice Address - State:MN
Practice Address - Zip Code:55057-3609
Practice Address - Country:US
Practice Address - Phone:507-237-6468
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-21
Last Update Date:2024-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty