=====================================================
General NPI Number Information
=====================================================
NPI Number | 1548870447
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | BABY MASTERMINDS INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/05/2020
-----------------------------------------------------
Last Update Date | 09/21/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 29 CASTLE PLACE
-----------------------------------------------------
City | NEW ROCHELLE
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10805
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 917-701-1273
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 941 MCLEAN AVE STE 219
-----------------------------------------------------
City | YONKERS
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10704-4107
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 917-701-1273
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT/CEO
-----------------------------------------------------
Name | RASHIDA RICHARDS
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 917-701-1273
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 252Y00000X
-----------------------------------------------------
Taxonomy Name | Early Intervention Provider Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------