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General NPI Number Information
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NPI Number | 1003769993
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Entity Type | Organization
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Legal Business Name | ELITE MINDS PEAK PERFORMANCE
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Dates
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Enumeration Date | 02/19/2026
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Last Update Date | 02/19/2026
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Provider Practice Location Address
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Address Line | 1870 THE EXCHANGE SE STE 220
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City | ATLANTA
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State | GA
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Zip | 30339-2171
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Country | US
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Telephone | 269-352-3753
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Fax | 269-352-3753
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Provider Business Mailing Address
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Address Line | 1870 THE EXCHANGE SE STE 220
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City | ATLANTA
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State | GA
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Zip | 30339-2171
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Country | US
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Telephone | 269-352-3753
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Fax | 269-352-3753
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Authorized Official
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Title or Position | CEO/OWNER
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Name | MRS. MILENA MASK
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Credential | NP
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Telephone | 269-352-3753
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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