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Organization
AUTHENTIC MINDS LLC
Active
Organization
AUTHENTIC MINDS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHIQUITTA MATHIS (ADMINISTRATOR)
(239) 271-5909
Entity
Organization
Contact information
Practice address
718 BAXTER AVENUE S, LEHIGH ACRES, FL 33974
(239) 271-5909
Mailing address
718 BAXTER AVE S, LEHIGH ACRES, FL 33974-9747
(239) 271-5909
Taxonomy
Speciality
Code
Description
License number
State
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
Primary
—
NULL
Other
Enumeration date
08/31/2017
Last updated
07/21/2022
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