Provider Demographics
NPI:1689424657
Name:MIND WELLBEING LLC
Entity Type:Organization
Organization Name:MIND WELLBEING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:
Authorized Official - First Name:OLUGBENGA
Authorized Official - Middle Name:AKINWALE
Authorized Official - Last Name:OBAJUWONLO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:702-541-4817
Mailing Address - Street 1:4442 AVERY PARK AVE
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89110-5488
Mailing Address - Country:US
Mailing Address - Phone:702-541-4817
Mailing Address - Fax:
Practice Address - Street 1:4442 AVERY PARK AVE
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89110-5488
Practice Address - Country:US
Practice Address - Phone:702-541-4817
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-25
Last Update Date:2024-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health