Provider Demographics
NPI:1457100174
Name:MIND-TOUCH PSYCHIATRY & INTEGRATIVE CARE, LLC
Entity type:Organization
Organization Name:MIND-TOUCH PSYCHIATRY & INTEGRATIVE CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:OLUWATOYIN
Authorized Official - Middle Name:
Authorized Official - Last Name:ALUKO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:682-253-2130
Mailing Address - Street 1:703 NETHERFIELD PKWY
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD
Mailing Address - State:TX
Mailing Address - Zip Code:76063-2236
Mailing Address - Country:US
Mailing Address - Phone:682-253-2130
Mailing Address - Fax:
Practice Address - Street 1:2125 E WARNER RD STE 103
Practice Address - Street 2:
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85284-3490
Practice Address - Country:US
Practice Address - Phone:682-253-2130
Practice Address - Fax:888-830-0569
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-15
Last Update Date:2024-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty