Healthcare Provider Details

I. General information

NPI: 1982425195
Provider Name (Legal Business Name): IMIND HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/21/2024
Last Update Date: 03/18/2026
Certification Date: 03/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4640 FORBES BLVD STE 375
LANHAM MD
20706-4323
US

IV. Provider business mailing address

4640 FORBES BLVD STE 375
LANHAM MD
20706-4323
US

V. Phone/Fax

Practice location:
  • Phone: 240-249-0989
  • Fax: 240-256-8887
Mailing address:
  • Phone: 240-249-0989
  • Fax: 240-256-8887

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name: KHANH-LINH FLYNN
Title or Position: CHIEF OPERATING OFFICER
Credential:
Phone: 240-249-0989