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General NPI Number Information
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NPI Number | 1114708799
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Entity Type | Organization
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Legal Business Name | MINDFUL MINDS PSYCHIATRY LLC
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Dates
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Enumeration Date | 10/10/2023
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Last Update Date | 12/03/2025
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Provider Practice Location Address
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Address Line | 1945 DOMINION WAY STE 110
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City | COLORADO SPRINGS
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State | CO
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Zip | 80918-1474
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Country | US
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Telephone | 720-458-5413
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Fax | 720-815-0397
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Provider Business Mailing Address
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Address Line | 16592 HIGH DESERT PL
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City | PARKER
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State | CO
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Zip | 80134-3044
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Country | US
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Telephone | 720-458-5413
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Fax | 720-815-0397
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Authorized Official
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Title or Position | CEO
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Name | DEIMYS DAILY VIGIL
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Credential |
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Telephone | 720-458-5413
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 364SP0808X
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Taxonomy Name | Psychiatric/Mental Health Clinical Nurse Specialist
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License Number |
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License Number State |
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