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General NPI Number Information
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NPI Number | 1851193171
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Entity Type | Organization
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Legal Business Name | LIFTING MINDS MENTAL HEALTH
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Dates
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Enumeration Date | 03/26/2025
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Last Update Date | 12/04/2025
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Provider Practice Location Address
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Address Line | 2020 COFFEE RD STE C1
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City | MODESTO
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State | CA
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Zip | 95355-2473
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Country | US
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Telephone | 209-818-2128
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 578132
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City | MODESTO
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State | CA
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Zip | 95357-8132
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Country | US
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Telephone | 209-818-2128
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MS. RACHELL LEVIEGE
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Credential |
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Telephone | 209-818-2128
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 175T00000X
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Taxonomy Name | Peer Specialist
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License Number |
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License Number State |
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