Healthcare Provider Details

I. General information

NPI: 1912811019
Provider Name (Legal Business Name): FAIR MINDS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/28/2026
Last Update Date: 09/28/2026
Certification Date: 09/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6423 N 49TH ST
MILWAUKEE WI
53223-6004
US

IV. Provider business mailing address

PO BOX 240673
MILWAUKEE WI
53224-9020
US

V. Phone/Fax

Practice location:
  • Phone: 414-218-4980
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number StateNULL

VIII. Authorized Official

Name: BRITTNEY FAIR
Title or Position: OWNER
Credential:
Phone: 414-218-4980