| NPI | 1740969567 |
|---|---|
| Former Legal Business Name | IMPACT MINDS |
| Entity Type | Organization |
| Authorized Contact | ASHANTI MENDHEIM President 469-518-3081 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310400000X Assisted Living Facility |
| Additional Taxonomies | 251G00000X Hospice Care, Community Based |
| 283Q00000X Psychiatric Hospital | |
| 3104A0625X Assisted Living Facility, Assisted Living, Mental Illness | |
| 311Z00000X Custodial Care Facility | |
| 3104A0630X Assisted Living Facility, Assisted Living, Behavioral Disturbances | |
| 310500000X Intermediate Care Facility, Mental Illness | |
| 311ZA0620X Custodial Care Facility, Adult Care Home | |
| 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities | |
| 320700000X Residential Treatment Facility, Physical Disabilities | |
| 320800000X Community Based Residential Treatment Facility, Mental Illness | |
| 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities | |
| 322D00000X Residential Treatment Facility, Emotionally Disturbed Children | |
| 324500000X Substance Abuse Rehabilitation Facility | |
| 3245S0500X Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children | |
| Enumeration Date | 2023-07-18 |
| Last Update Date | 2023-07-18 |