Provider Demographics
NPI:1255039830
Name:EMPOWERING MINDS BEHAVIORAL SERVICES LLC
Entity type:Organization
Organization Name:EMPOWERING MINDS BEHAVIORAL SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BCBA
Authorized Official - Prefix:MRS
Authorized Official - First Name:NATASHA
Authorized Official - Middle Name:
Authorized Official - Last Name:PERRY
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:850-333-3103
Mailing Address - Street 1:6230 LAPIS LN
Mailing Address - Street 2:
Mailing Address - City:CRESTVIEW
Mailing Address - State:FL
Mailing Address - Zip Code:32539-5425
Mailing Address - Country:US
Mailing Address - Phone:850-333-3103
Mailing Address - Fax:
Practice Address - Street 1:6230 LAPIS LN
Practice Address - Street 2:
Practice Address - City:CRESTVIEW
Practice Address - State:FL
Practice Address - Zip Code:32539-5425
Practice Address - Country:US
Practice Address - Phone:850-400-6098
Practice Address - Fax:866-265-8817
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-22
Last Update Date:2023-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty