=====================================================
General NPI Number Information
=====================================================
NPI Number | 1700581337
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | BIOMINDS BEHAVIORAL HEALTH LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/03/2023
-----------------------------------------------------
Last Update Date | 09/01/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 227 W MAIN RD
-----------------------------------------------------
City | MIDDLETOWN
-----------------------------------------------------
State | RI
-----------------------------------------------------
Zip | 02842-4900
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 346-933-9260
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 4638 BRAZOS SHORES DR
-----------------------------------------------------
City | SUGAR LAND
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77479-7077
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 832-258-0772
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | SOLE OWNER
-----------------------------------------------------
Name | BAYO IVYL OWENS
-----------------------------------------------------
Credential | DNP PMHNP
-----------------------------------------------------
Telephone | 832-258-0772
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QM0801X
-----------------------------------------------------
Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 363LP0808X
-----------------------------------------------------
Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------