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General NPI Number Information
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NPI Number | 1851275473
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Entity Type | Organization
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Legal Business Name | MIND REHAB LLC
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Dates
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Enumeration Date | 08/05/2025
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Last Update Date | 08/05/2025
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Provider Practice Location Address
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Address Line | 5725 S VALLEY VIEW BLVD STE 5 #277447
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City | LAS VEGAS
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State | NV
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Zip | 89118
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Country | US
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Telephone | 888-434-6463
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Fax |
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Provider Business Mailing Address
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Address Line | 437 N KANAI DR
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City | PORTERVILLE
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State | CA
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Zip | 93257-6912
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Country | US
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Telephone | 559-783-3204
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | ASHLEY D MILLER
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Credential | PMHNP-BC
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Telephone | 559-783-3204
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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