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General NPI Number Information
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NPI Number | 1427687714
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Entity Type | Organization
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Legal Business Name | MASTERMIND CARE, INC
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Dates
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Enumeration Date | 04/07/2020
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Last Update Date | 01/23/2025
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Provider Practice Location Address
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Address Line | 541 S STATE ROAD 7 STE 7
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City | MARGATE
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State | FL
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Zip | 33068-1711
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Country | US
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Telephone | 954-548-6303
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Fax |
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Provider Business Mailing Address
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Address Line | 541 S STATE ROAD 7 STE 7
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City | MARGATE
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State | FL
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Zip | 33068-1711
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Country | US
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Telephone | 954-548-6303
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Fax |
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICER
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Name | MRS. JEANNIE LOUISE BARREDA
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Credential |
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Telephone | 954-548-6303
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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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 | 261QR0405X
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Taxonomy Name | Substance Use Disorder Rehabilitation Clinic/Center
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License Number |
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License Number State |
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