Provider Demographics
NPI:1245520683
Name:ENQUIRING MINDS REHAB LLC
Entity type:Organization
Organization Name:ENQUIRING MINDS REHAB LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAM MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:GBENGA
Authorized Official - Last Name:FADIPE
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:832-875-1222
Mailing Address - Street 1:7235 CALCUTTA SPRING DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77083-8051
Mailing Address - Country:US
Mailing Address - Phone:832-875-1222
Mailing Address - Fax:
Practice Address - Street 1:18018 MABLE POND LN
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:TX
Practice Address - Zip Code:77407-5266
Practice Address - Country:US
Practice Address - Phone:832-875-1222
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-19
Last Update Date:2011-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX261QM0801103TR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TR0400XBehavioral Health & Social Service ProvidersPsychologistRehabilitationGroup - Multi-Specialty