Provider Demographics
NPI: | 1790419505 |
---|---|
Name: | HEART AND MIND HEALTH PARTNERS LLC |
Entity Type: | Organization |
Organization Name: | HEART AND MIND HEALTH PARTNERS LLC |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | OWNER |
Authorized Official - Prefix: | |
Authorized Official - First Name: | EMEKA |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | MADU |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 702-376-3127 |
Mailing Address - Street 1: | 1050 E FLAMINGO RD # 1939 |
Mailing Address - Street 2: | |
Mailing Address - City: | LAS VEGAS |
Mailing Address - State: | NV |
Mailing Address - Zip Code: | 89119-7427 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 775-419-3876 |
Mailing Address - Fax: | 702-442-0992 |
Practice Address - Street 1: | 1050 E FLAMINGO RD # 1939 |
Practice Address - Street 2: | |
Practice Address - City: | LAS VEGAS |
Practice Address - State: | NV |
Practice Address - Zip Code: | 89119-7427 |
Practice Address - Country: | US |
Practice Address - Phone: | 775-419-3876 |
Practice Address - Fax: | 702-442-0992 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2022-07-16 |
Last Update Date: | 2023-09-27 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 363L00000X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Group - Multi-Specialty | |
No | 207Q00000X | Allopathic & Osteopathic Physicians | Family Medicine | Group - Multi-Specialty | |
No | 207RA0001X | Allopathic & Osteopathic Physicians | Internal Medicine | Advanced Heart Failure and Transplant Cardiology | Group - Multi-Specialty |
No | 207RC0000X | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease | Group - Multi-Specialty |
No | 207RI0011X | Allopathic & Osteopathic Physicians | Internal Medicine | Interventional Cardiology | Group - Multi-Specialty |
No | 246W00000X | Technologists, Technicians & Other Technical Service Providers | Technician, Cardiology | Group - Multi-Specialty | |
No | 246X00000X | Technologists, Technicians & Other Technical Service Providers | Specialist/Technologist Cardiovascular | Group - Multi-Specialty | |
No | 251S00000X | Agencies | Community/Behavioral Health | Group - Multi-Specialty | |
No | 261QM0850X | Ambulatory Health Care Facilities | Clinic/Center | Adult Mental Health | Group - Multi-Specialty |
Yes | 363LA2100X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Acute Care | Group - Multi-Specialty |
No | 363LF0000X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family | Group - Multi-Specialty |
No | 363LP0808X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Psychiatric/Mental Health | Group - Multi-Specialty |