# MINDFUL HEART FAMILY HEALTH LLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** MINDFUL HEART FAMILY HEALTH LLC
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1104390038
- **Legal business name:** MINDFUL HEART FAMILY HEALTH LLC
- **Authorized official:** JIKEALA TAYLOR (CHIEF EXECUTIVE OFFICER)
- **Authorized official phone:** (678) 515-6507

## Contact information

- **Practice address:** 8670 W CHEYENNE AVE STE 218, LAS VEGAS, NV 89129
- **Practice address phone:** (678) 515-6507
- **Mailing address:** 8670 W CHEYENNE AVE STE 218, LAS VEGAS, NV 89129-7457
- **Mailing address phone:** (678) 515-6507

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YA0400X | Addiction (Substance Use Disorder) Counselor | — | NULL | Yes |
| 101YA0400X | Addiction (Substance Use Disorder) Counselor | — | — | Yes |
| 251S00000X | Community/Behavioral Health Agency | — | NULL | — |

## Other

- **Enumeration date:** 01/14/2019
- **Last updated:** 06/14/2019