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Organization
MIND ABOVE MATTER LLC
Active
Organization
MIND ABOVE MATTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEFF ISAAC (CONTROLLER)
(732) 927-7080
Entity
Organization
Contact information
Practice address
1100 RAIDER DR, EULESS, TX 76040-6252
(817) 447-3001
(817) 289-5699
Mailing address
PO BOX 446, LAKEWOOD, NJ 08701-0446
(817) 447-3001
(817) 289-5623
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
—
—
1041C0700X
Clinical Social Worker
—
—
251B00000X
Case Management Agency
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
12/26/2018
Last updated
11/03/2023
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