Provider Demographics
NPI:1710218482
Name:GUIDING YOUNG MINDS
Entity Type:Organization
Organization Name:GUIDING YOUNG MINDS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:NADINE
Authorized Official - Middle Name:
Authorized Official - Last Name:DOMOND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-329-3268
Mailing Address - Street 1:1308 HAWK NEST WAY
Mailing Address - Street 2:SUITE 104
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23451
Mailing Address - Country:US
Mailing Address - Phone:757-329-3268
Mailing Address - Fax:
Practice Address - Street 1:1308 HAWK NEST WAY
Practice Address - Street 2:SUITE 104
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23451
Practice Address - Country:US
Practice Address - Phone:757-329-3268
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-20
Last Update Date:2010-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health