Provider Demographics
NPI:1407299928
Name:HEALTH MINDED KIDS
Entity Type:Organization
Organization Name:HEALTH MINDED KIDS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CRYSTAL
Authorized Official - Middle Name:
Authorized Official - Last Name:NASSER
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:561-352-6192
Mailing Address - Street 1:1101 SABAL RIDGE CIR
Mailing Address - Street 2:APT B
Mailing Address - City:PALM BEACH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33418-8969
Mailing Address - Country:US
Mailing Address - Phone:561-352-6192
Mailing Address - Fax:
Practice Address - Street 1:11382 PROSPERITY FARMS RD
Practice Address - Street 2:SUITE 126
Practice Address - City:PALM BEACH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33410-3463
Practice Address - Country:US
Practice Address - Phone:561-352-6192
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-15
Last Update Date:2013-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health