MEDICARE: GROWING MINDS ABA, LLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	251C00000X	Developmentally Disabled Services Day Training Agency
2	253Z00000X	In Home Supportive Care Agency
3	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1053112060
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GROWING MINDS ABA, LLC

Provider Business Mailing Address
First Line	:	2893 MACH BLUE AVE
Second Line	:
City	:	NORTH LAS VEGAS
State	:	NV
Zip	:	89086-1763
Country	:	US
Telephone Number	:	702-789-8524
Fax Number	:

Provider Business Practice Location Address
First Line	:	2893 MACH BLUE AVE
Second Line	:
City	:	NORTH LAS VEGAS
State	:	NV
Zip	:	89086-1763
Country	:	US
Telephone Number	:	702-789-8524
Fax Number	:

Authorized Official
Title or Position	:	MANAGING MEMBER
Name	:	NNEDINMA FIELDS
Credential	:	BCBA
Telephone Number	:	702-789-8524

Provider Enumeration Date	:	03/24/2025
Last Update Date	:	03/24/2025

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