Provider Demographics
NPI:1821879917
Name:SOUNDMIND CARE
Entity Type:Organization
Organization Name:SOUNDMIND CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:LEMFEYIN WISIY
Authorized Official - Last Name:TATA-ACHA
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:818-900-3573
Mailing Address - Street 1:16117 COLUMBUS LN
Mailing Address - Street 2:
Mailing Address - City:NORTH HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91343-2160
Mailing Address - Country:US
Mailing Address - Phone:818-900-3573
Mailing Address - Fax:747-237-3305
Practice Address - Street 1:113 N SAN VICENTE BLVD STE 268
Practice Address - Street 2:
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90211-2329
Practice Address - Country:US
Practice Address - Phone:747-732-4549
Practice Address - Fax:747-237-3305
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-13
Last Update Date:2023-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)