Basic Information
| Provider Information | |||||||||
| NPI: | 1295487916 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | CALM MINDS LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4911 GRAND AVE | ||||||||
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| City: | OMAHA | ||||||||
| State: | NE | ||||||||
| PostalCode: | 681042380 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5627465150 | ||||||||
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| Practice Location | |||||||||
| Address1: | 4911 GRAND AVE | ||||||||
| Address2: | |||||||||
| City: | OMAHA | ||||||||
| State: | NE | ||||||||
| PostalCode: | 681042380 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5627465150 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 01/24/2022 | ||||||||
| LastUpdateDate: | 01/24/2022 | ||||||||
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| AuthorizedOfficialLastName: | LUCK | ||||||||
| AuthorizedOfficialFirstName: | JONNAE | ||||||||
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| AuthorizedOfficialTitleorPosition: | OWNER/THERAPIST | ||||||||
| AuthorizedOfficialTelephone: | 5627465150 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| NPICertificationDate: | 01/24/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QM0855X | Y | Ambulatory Health Care Facilities | Clinic/Center | Adolescent and Children Mental Health |
No ID Information.