Organization
GROUNDWORK PSYCHIATRY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. FREDERICK WILLIAM HOUTS MD (SOLE OWNER)
(612) 808-9375
Entity
Organization
Contact information
Practice address
2419 NICOLLET AVE, MINNEAPOLIS, MN 55404-3450
(612) 871-3320
Mailing address
3109 W 50TH ST # 317, MINNEAPOLIS, MN 55410-2102
(612) 808-9375
Taxonomy
Speciality
Code
Description
License number
State
2084F0202X
Forensic Psychiatry Physician
61077
MN
2084F0202X
Forensic Psychiatry Physician
7312
AK
2084F0202X
Forensic Psychiatry Physician
A116329
CA
2084F0202X
Forensic Psychiatry Physician
D0070374
MD
2084P0800X
Psychiatry Physician
Primary
61077
MN
2084P0800X
Psychiatry Physician
7312
AK
2084P0800X
Psychiatry Physician
A116329
CA
2084P0800X
Psychiatry Physician
D0070374
MD
Other
Enumeration date
08/15/2017
Last updated
08/15/2017
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