Provider Demographics
NPI:1891090502
Name:MENTAL MISSIONS LLC
Entity Type:Organization
Organization Name:MENTAL MISSIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:BYRON
Authorized Official - Middle Name:CRUMP
Authorized Official - Last Name:JARRETT
Authorized Official - Suffix:SR
Authorized Official - Credentials:
Authorized Official - Phone:515-274-8720
Mailing Address - Street 1:7200 FOREST CT
Mailing Address - Street 2:
Mailing Address - City:WINDSOR HEIGHTS
Mailing Address - State:IA
Mailing Address - Zip Code:50324-1330
Mailing Address - Country:US
Mailing Address - Phone:515-274-8720
Mailing Address - Fax:
Practice Address - Street 1:7200 FOREST CT
Practice Address - Street 2:
Practice Address - City:WINDSOR HEIGHTS
Practice Address - State:IA
Practice Address - Zip Code:50324-1330
Practice Address - Country:US
Practice Address - Phone:515-274-8720
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-12
Last Update Date:2011-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No252Y00000XAgenciesEarly Intervention Provider Agency
No253Z00000XAgenciesIn Home Supportive Care