Provider Demographics
NPI:1871191726
Name:BEAUTIFUL MINDS MENTAL HEALTH AND PRIMARY CARE CLINIC
Entity Type:Organization
Organization Name:BEAUTIFUL MINDS MENTAL HEALTH AND PRIMARY CARE CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LASHANDIA
Authorized Official - Middle Name:
Authorized Official - Last Name:BINION
Authorized Official - Suffix:
Authorized Official - Credentials:CADC-I
Authorized Official - Phone:702-331-1917
Mailing Address - Street 1:3550 W CHEYENNE AVE STE 100-130
Mailing Address - Street 2:
Mailing Address - City:NORTH LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89032-8212
Mailing Address - Country:US
Mailing Address - Phone:702-331-1917
Mailing Address - Fax:
Practice Address - Street 1:3550 W CHEYENNE AVE STE 100-130
Practice Address - Street 2:
Practice Address - City:NORTH LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89032-8212
Practice Address - Country:US
Practice Address - Phone:702-331-1917
Practice Address - Fax:702-331-5219
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BEAUTIFUL MINDS BEHAVIORAL HEALTH FACILITY LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-10-13
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary CareGroup - Multi-Specialty
No261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty