Healthcare Provider Details

I. General information

NPI: 1518109313
Provider Name (Legal Business Name): THE MIND RESEARCH NETWORK
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/25/2009
Last Update Date: 03/25/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1101 YALE BLVD NE
ALBUQUERQUE NM
87131-0001
US

IV. Provider business mailing address

1101 YALE BLVD NE
ALBUQUERQUE NM
87131-0001
US

V. Phone/Fax

Practice location:
  • Phone: 505-272-2083
  • Fax: 505-272-8002
Mailing address:
  • Phone: 505-272-2083
  • Fax: 505-272-8002

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM1200X
TaxonomyMagnetic Resonance Imaging (MRI) Clinic/Center
License NumberNA
License Number State

VIII. Authorized Official

Name: MS. MELISSA MERCEDES HILLEARY
Title or Position: COO
Credential:
Phone: 505-272-2083