Provider Demographics
NPI:1598527053
Name:MIND ALIGNMENT INTEGRATIVE PSYSHIATRY LLC
Entity Type:Organization
Organization Name:MIND ALIGNMENT INTEGRATIVE PSYSHIATRY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PMHNP
Authorized Official - Prefix:
Authorized Official - First Name:BOLUTIFE
Authorized Official - Middle Name:
Authorized Official - Last Name:AKINREMI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-799-0821
Mailing Address - Street 1:565 S 165TH AVE
Mailing Address - Street 2:
Mailing Address - City:GOODYEAR
Mailing Address - State:AZ
Mailing Address - Zip Code:85338-2550
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:565 S 165TH AVE
Practice Address - Street 2:
Practice Address - City:GOODYEAR
Practice Address - State:AZ
Practice Address - Zip Code:85338-2550
Practice Address - Country:US
Practice Address - Phone:602-799-0821
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-29
Last Update Date:2024-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty