Provider Demographics
NPI:1891174132
Name:TELEMIND INC
Entity Type:Organization
Organization Name:TELEMIND INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:ANTON
Authorized Official - Middle Name:
Authorized Official - Last Name:FISHER
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:725-333-2411
Mailing Address - Street 1:3227 MEADE AVE STE 5B
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89102-7810
Mailing Address - Country:US
Mailing Address - Phone:725-333-2411
Mailing Address - Fax:702-952-5257
Practice Address - Street 1:3227 MEADE AVE STE 5B
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89102-7810
Practice Address - Country:US
Practice Address - Phone:725-333-2411
Practice Address - Fax:702-952-5257
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-20
Last Update Date:2021-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV1891174132Medicaid