Provider Demographics
NPI:1770312258
Name:HEALING MINDS BEHAVIORAL HEALTH
Entity type:Organization
Organization Name:HEALING MINDS BEHAVIORAL HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HEALTH DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SHAMEKIA
Authorized Official - Middle Name:SHEREE
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-764-8464
Mailing Address - Street 1:7874 CLEARWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89123-0302
Mailing Address - Country:US
Mailing Address - Phone:702-764-8464
Mailing Address - Fax:
Practice Address - Street 1:7874 CLEARWOOD AVE
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89123-0302
Practice Address - Country:US
Practice Address - Phone:702-764-8464
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-31
Last Update Date:2024-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health