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General NPI Number Information
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NPI Number | 1275307340
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Entity Type | Organization
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Legal Business Name | MINDSPACE, LLC
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Dates
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Enumeration Date | 11/09/2023
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Last Update Date | 06/25/2025
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Provider Practice Location Address
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Address Line | 1151 S NEVADA HIGHWAY 160 STE 2
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City | PAHRUMP
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State | NV
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Zip | 89048-7711
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Country | US
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Telephone | 775-473-5050
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Fax | 775-473-5252
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Provider Business Mailing Address
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Address Line | 1151 S NV 160
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City | PAHRUMP
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State | NV
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Zip | 89048
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DEREK GRIFFITH
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Credential | PMHNP
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Telephone | 775-473-5050
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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