Provider Demographics
NPI:1982288676
Name:OPENING MINDS, INC.
Entity Type:Organization
Organization Name:OPENING MINDS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS SERVICES MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MALY
Authorized Official - Middle Name:
Authorized Official - Last Name:BOONSALAT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:209-616-9960
Mailing Address - Street 1:6166 DILL CT
Mailing Address - Street 2:
Mailing Address - City:STOCKTON
Mailing Address - State:CA
Mailing Address - Zip Code:95215-1003
Mailing Address - Country:US
Mailing Address - Phone:209-636-3917
Mailing Address - Fax:
Practice Address - Street 1:6166 DILL CT
Practice Address - Street 2:
Practice Address - City:STOCKTON
Practice Address - State:CA
Practice Address - Zip Code:95215-1003
Practice Address - Country:US
Practice Address - Phone:209-227-0544
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-08
Last Update Date:2021-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty