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NPI Code Detail

MEDICARE: MIND UP LLC

MEDICARE: MIND UP 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
1101YM0800XMental Health Counselor
2261Q00000XClinic/Center

General Provider Information

NPI Number : 1679292338
Entity Type Code : Organization
Provider Name (Legal Business Name) : MIND UP LLC
Provider Business Mailing Address
First Line : 7968 DORINDA AVE
Second Line :
City : LAS VEGAS
State : NV
Zip : 89147-5035
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 900 E DESERT INN RD STE 104-B
Second Line :
City : LAS VEGAS
State : NV
Zip : 89109-9398
Country : US
Telephone Number : 702-809-4555
Fax Number :
Authorized Official
Title or Position : OWNER
Name : REBECA COHEN
Credential :
Telephone Number : 702-809-4555
Provider Enumeration Date : 08/25/2022
Last Update Date : 08/25/2022

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Directions to “MIND UP LLC ” Practice Location

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