Provider Demographics
NPI:1649046756
Name:MINDFUL JOURNEYS LLC
Entity type:Organization
Organization Name:MINDFUL JOURNEYS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:STARLA
Authorized Official - Middle Name:
Authorized Official - Last Name:HOWERTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-574-5475
Mailing Address - Street 1:8604 COPPER MOUNTAIN AVE
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89129-7610
Mailing Address - Country:US
Mailing Address - Phone:702-574-5475
Mailing Address - Fax:
Practice Address - Street 1:2340 PASEO DEL PRADO STE D101
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89102-4340
Practice Address - Country:US
Practice Address - Phone:702-574-5475
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-29
Last Update Date:2023-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health