MEDICARE: MIND THAT MATTERS 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	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1689201501
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MIND THAT MATTERS LLC

Provider Business Mailing Address
First Line	:	2871 GLASS VINE CT
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89117-3402
Country	:	US
Telephone Number	:	626-646-9663
Fax Number	:

Provider Business Practice Location Address
First Line	:	2871 GLASS VINE CT
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89117-3402
Country	:	US
Telephone Number	:	626-646-9663
Fax Number	:

Authorized Official
Title or Position	:	MANAGING MEMBER
Name	:	EDWIN RAMIRO VASQUEZ
Credential	:
Telephone Number	:	626-646-9663

Provider Enumeration Date	:	03/23/2020
Last Update Date	:	03/23/2020

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Directions to “MIND THAT MATTERS LLC ” Practice Location

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