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General NPI Number Information
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NPI Number | 1043196074
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Entity Type | Organization
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Legal Business Name | MASTERMIND BRAIN TRAINING, LLC DBA LEARNINGRX HIGHLANDS RANCH
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Dates
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Enumeration Date | 08/14/2025
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Last Update Date | 08/14/2025
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Provider Practice Location Address
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Address Line | 9090 RIDGELINE BLVD BLDG STE 206
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City | HIGHLANDS RANCH
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State | CO
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Zip | 80129-2504
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Country | US
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Telephone | 303-955-2959
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Fax |
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Provider Business Mailing Address
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Address Line | 9090 RIDGELINE BLVD BLDG STE 206
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City | HIGHLANDS RANCH
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State | CO
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Zip | 80129-2504
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Country | US
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Telephone | 303-955-2959
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Fax |
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | DOUGLAS MIRACLE
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Credential |
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Telephone | 303-955-2959
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225400000X
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Taxonomy Name | Rehabilitation Practitioner
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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 | 261QR0400X
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Taxonomy Name | Rehabilitation Clinic/Center
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License Number |
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License Number State |
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