Healthcare Provider Details

I. General information

NPI: 1265031504
Provider Name (Legal Business Name): ENGAGING MINDS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/19/2020
Last Update Date: 11/10/2025
Certification Date: 11/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2200 BOULEVARD STE C
COLONIAL HEIGHTS VA
23834-2305
US

IV. Provider business mailing address

2200 BOULEVARD STE C
COLONIAL HEIGHTS VA
23834-2305
US

V. Phone/Fax

Practice location:
  • Phone: 804-898-3988
  • Fax:
Mailing address:
  • Phone: 804-898-3988
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number
License Number State

VIII. Authorized Official

Name: ROBERT BRADLEY
Title or Position: OWNER
Credential:
Phone: 804-938-1691