MEDICARE: ELITE MINDS PEAK PERFORMANCE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	261QM0850X	Adult Mental Health Clinic/Center
2	251S00000X	Community/Behavioral Health Agency
3	363LF0000X	Family Nurse Practitioner

General Provider Information

NPI Number	:	1003769993
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ELITE MINDS PEAK PERFORMANCE

Provider Business Mailing Address
First Line	:	1870 THE EXCHANGE SE STE 220
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30339-2171
Country	:	US
Telephone Number	:	269-352-3753
Fax Number	:	269-352-3753

Provider Business Practice Location Address
First Line	:	1870 THE EXCHANGE SE STE 220
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30339-2171
Country	:	US
Telephone Number	:	269-352-3753
Fax Number	:	269-352-3753

Authorized Official
Title or Position	:	CEO/OWNER
Name	:	MRS. MILENA MASK
Credential	:	NP
Telephone Number	:	269-352-3753

Provider Enumeration Date	:	02/19/2026
Last Update Date	:	02/19/2026

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