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Organization

ENLIGHTENMENT PSYCHIATRY LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MACKENZIE SNORTUM (OWNER)
(320) 321-9599
Entity
Organization

Contact information

Practice address
1011 1ST ST E STE 5, PARK RAPIDS, MN 56470-1764
(320) 321-9599
(877) 962-3624
Mailing address
1011 1ST ST E STE 5, PARK RAPIDS, MN 56470-1764
(320) 321-9599
(877) 962-3624

Taxonomy

Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1013555887
NPI
MN
Enumeration date
12/09/2021
Last updated
03/31/2026
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