Provider Demographics
NPI:1275424467
Name:AZSENTIA HEALTH
Entity type:Organization
Organization Name:AZSENTIA HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PMHNP-BC/CEO
Authorized Official - Prefix:
Authorized Official - First Name:AZEEZ
Authorized Official - Middle Name:FOLORUNSHO
Authorized Official - Last Name:RUFAI
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:320-310-7580
Mailing Address - Street 1:1015 CORY LN
Mailing Address - Street 2:
Mailing Address - City:SAINT CLOUD
Mailing Address - State:MN
Mailing Address - Zip Code:56303-4689
Mailing Address - Country:US
Mailing Address - Phone:320-310-7580
Mailing Address - Fax:
Practice Address - Street 1:601 W SAINT GERMAIN ST
Practice Address - Street 2:
Practice Address - City:SAINT CLOUD
Practice Address - State:MN
Practice Address - Zip Code:56301-3665
Practice Address - Country:US
Practice Address - Phone:320-310-7580
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-14
Last Update Date:2025-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health