Provider Demographics
NPI:1295306355
Name:MINDFUL BEHAVIORAL SOLUTIONS LLC
Entity type:Organization
Organization Name:MINDFUL BEHAVIORAL SOLUTIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER OF ENTITY
Authorized Official - Prefix:
Authorized Official - First Name:FAITH
Authorized Official - Middle Name:I
Authorized Official - Last Name:OGALA
Authorized Official - Suffix:
Authorized Official - Credentials:MSN, PMHNP-BC
Authorized Official - Phone:888-550-4842
Mailing Address - Street 1:8811 TEEL PKWY STE 100-5476
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75035-4201
Mailing Address - Country:US
Mailing Address - Phone:888-550-4842
Mailing Address - Fax:888-550-3391
Practice Address - Street 1:8035 E R L THORNTON FWY STE 334
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75228-7018
Practice Address - Country:US
Practice Address - Phone:888-550-4842
Practice Address - Fax:888-550-3391
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-08
Last Update Date:2021-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty