# AUTHENTIC MINDS LLC

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

## Provider details

- **NPI number:** 1659899565
- **Authorized official:** SHIQUITTA MATHIS (ADMINISTRATOR)
- **Authorized official phone:** (239) 271-5909

## Contact information

- **Practice address:** 718 BAXTER AVENUE S, LEHIGH ACRES, FL 33974
- **Practice address phone:** (239) 271-5909
- **Mailing address:** 718 BAXTER AVE S, LEHIGH ACRES, FL 33974-9747
- **Mailing address phone:** (239) 271-5909

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 385HR2060X | Child Intellectual and/or Developmental Disabilities Respite Care | — | NULL | Yes |

## Other

- **Enumeration date:** 08/31/2017
- **Last updated:** 07/21/2022