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General NPI Number Information
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NPI Number | 1801781521
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Entity Type | Organization
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Legal Business Name | ELEVATED MINDS LLC
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Dates
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Enumeration Date | 06/11/2025
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Last Update Date | 06/11/2025
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Provider Practice Location Address
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Address Line | 1209 MOUNTAIN ROAD PL NE # 6235
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City | ALBUQUERQUE
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State | NM
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Zip | 87110-7845
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Country | US
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Telephone | 575-209-8309
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Fax |
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Provider Business Mailing Address
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Address Line | 1209 MOUNTAIN ROAD PL NE # 6235
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City | ALBUQUERQUE
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State | NM
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Zip | 87110-7845
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Country | US
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Telephone | 575-209-8309
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MEMORY MABUGU
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Credential |
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Telephone | 412-390-5826
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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