Provider Demographics
NPI:1407402415
Name:MIND INNOVATION SERVICES LLC
Entity Type:Organization
Organization Name:MIND INNOVATION SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:APRN
Authorized Official - Prefix:
Authorized Official - First Name:HELENA
Authorized Official - Middle Name:
Authorized Official - Last Name:MORRIS
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:860-716-4292
Mailing Address - Street 1:10 HOLLIS LNDG
Mailing Address - Street 2:
Mailing Address - City:GLASTONBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06033-3856
Mailing Address - Country:US
Mailing Address - Phone:860-716-4292
Mailing Address - Fax:
Practice Address - Street 1:10 HOLLIS LNDG
Practice Address - Street 2:
Practice Address - City:GLASTONBURY
Practice Address - State:CT
Practice Address - Zip Code:06033-3856
Practice Address - Country:US
Practice Address - Phone:860-716-4292
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-15
Last Update Date:2019-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental HealthGroup - Single Specialty