Organization
UPSIDE PSYCHIATRIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MIRIAM ELAINE TELL NP (PMHNP)
(218) 766-5344
Entity
Organization
Contact information
Practice address
1526 30TH ST NW, BEMIDJI, MN 56601-4140
(218) 751-0887
Mailing address
PO BOX 1795, BEMIDJI, MN 56619-1795
(218) 766-5344
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
R127204-4
MN
273R00000X
Psychiatric Hospital Unit
R1272044
MN
Other
Enumeration date
01/06/2011
Last updated
12/17/2013
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