Provider Demographics
NPI:1518546753
Name:TRANSFORMING MINDS LLC
Entity Type:Organization
Organization Name:TRANSFORMING MINDS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR/ MANAGING PARTNER
Authorized Official - Prefix:MS
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:REINOLD
Authorized Official - Suffix:
Authorized Official - Credentials:QMHA
Authorized Official - Phone:702-237-4866
Mailing Address - Street 1:1260 BOURBON ST APT 1
Mailing Address - Street 2:
Mailing Address - City:PAHRUMP
Mailing Address - State:NV
Mailing Address - Zip Code:89048-6592
Mailing Address - Country:US
Mailing Address - Phone:484-891-1044
Mailing Address - Fax:
Practice Address - Street 1:1260 BOURBON ST APT 1
Practice Address - Street 2:
Practice Address - City:PAHRUMP
Practice Address - State:NV
Practice Address - Zip Code:89048-6592
Practice Address - Country:US
Practice Address - Phone:484-891-1044
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FAITH FOR ACTION INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-04-05
Last Update Date:2021-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)Group - Multi-Specialty