Organization
EXCEPTIONAL MINDS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DOMINQUE INGRAM (OWNER)
(602) 592-0503
Entity
Organization
Contact information
Practice address
8325 JEEVES CIR, LAS VEGAS, NV 89149-4947
(602) 592-0503
Mailing address
8325 JEEVES CIR, LAS VEGAS, NV 89149-4947
(602) 592-0503
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
NV20171737643
NV
Other
Enumeration date
11/15/2017
Last updated
11/16/2017
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