MEDICARE: MINDS & EMPOWERMENT LLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103K00000X	Behavior Analyst

General Provider Information

NPI Number	:	1356686521
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MINDS & EMPOWERMENT LLC

Provider Business Mailing Address
First Line	:	18415 RANCH VIEW TRL
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77073-6403
Country	:	US
Telephone Number	:	832-638-9322
Fax Number	:	832-947-4025

Provider Business Practice Location Address
First Line	:	18415 RANCH VIEW TRL
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77073-6403
Country	:	US
Telephone Number	:	832-638-9322
Fax Number	:	832-947-4025

Authorized Official
Title or Position	:	OWNER
Name	:	CURRY WAYNE YOUNG
Credential	:
Telephone Number	:	832-638-9322

Provider Enumeration Date	:	11/29/2012
Last Update Date	:	06/04/2013

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