MEDICARE: MIND 24-7 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	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number	:	1528650959
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MIND 24-7 LLC

Provider Business Mailing Address
First Line	:	1465 N SCOTTSDALE RD STE 400
Second Line	:
City	:	SCOTTSDALE
State	:	AZ
Zip	:	85257-3634
Country	:	US
Telephone Number	:	844-646-3247
Fax Number	:	480-548-4046

Provider Business Practice Location Address
First Line	:	1465 N SCOTTSDALE RD STE 400
Second Line	:
City	:	SCOTTSDALE
State	:	AZ
Zip	:	85257-3634
Country	:	US
Telephone Number	:	844-646-3247
Fax Number	:	480-548-4046

Authorized Official
Title or Position	:	DIRECTOR OF CREDENTIALING
Name	:	AISHA LYNN DEPRIEST
Credential	:
Telephone Number	:	480-369-4008

Provider Enumeration Date	:	02/08/2021
Last Update Date	:	03/06/2023

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Directions to “MIND 24-7 LLC ” Practice Location

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