MEDICARE: MIND POWER CREATIVITY CENTER LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103K00000X	Behavior Analyst

General Provider Information

NPI Number	:	1235061805
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MIND POWER CREATIVITY CENTER LLC

Provider Business Mailing Address
First Line	:	5133 N BRONCO LN
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89130-1912
Country	:	US
Telephone Number	:	702-809-1038
Fax Number	:

Provider Business Practice Location Address
First Line	:	5133 N BRONCO LN
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89130-1912
Country	:	US
Telephone Number	:	702-809-1038
Fax Number	:

Authorized Official
Title or Position	:	FOUNDER & CLINICAL DIRECTOR
Name	:	DR. GABRIELA LEUTERIO GRASSO
Credential	:	EDD,MED,MS,BCBA,LBA
Telephone Number	:	702-809-1038

Provider Enumeration Date	:	05/29/2026
Last Update Date	:	05/29/2026

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