Organization
BRILLIANT MINDS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNA OSTER BCBA (OWNER)
(815) 508-5303
Entity
Organization
Contact information
Practice address
1740 SPRINGTIME CT, DYER, IN 46311-2185
(815) 508-5303
Mailing address
1740 SPRINGTIME CT, DYER, IN 46311-2185
(815) 508-5303
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1972882470
—
IN
Enumeration date
09/23/2021
Last updated
09/23/2021
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