Provider Demographics
NPI:1669231692
Name:BRILLIANT MINDS CHILDREN'S CENTER
Entity type:Organization
Organization Name:BRILLIANT MINDS CHILDREN'S CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:UNDREA
Authorized Official - Middle Name:
Authorized Official - Last Name:CATO-STEELE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:424-382-8670
Mailing Address - Street 1:7141 SANTA MONICA BLVD APT 408
Mailing Address - Street 2:
Mailing Address - City:WEST HOLLYWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90046-3466
Mailing Address - Country:US
Mailing Address - Phone:424-382-8670
Mailing Address - Fax:
Practice Address - Street 1:4747 PENNWOOD AVE APT 2050
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89102-7054
Practice Address - Country:US
Practice Address - Phone:424-382-8670
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-13
Last Update Date:2024-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty
No251S00000XAgenciesCommunity/Behavioral HealthGroup - Multi-Specialty
No261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty