# IMIND GERIATRICS AND BEHAVIORAL HEALTH LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1265174775
- **Authorized official:** DAVID COOK (MANAGER)
- **Authorized official phone:** (731) 267-3154

## Contact information

- **Practice address:** 312 GREENHILL DR, JACKSON, TN 38305-5716
- **Practice address phone:** (731) 300-0810
- **Mailing address:** 65 MURRAY GUARD DR, JACKSON, TN 38305-3628
- **Mailing address phone:** (731) 300-0810

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YM0800X | Mental Health Counselor | — | NULL | — |
| 101YM0800X | Mental Health Counselor | — | — | — |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | NULL | Yes |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 04/13/2022
- **Last updated:** 01/03/2025