Organization
IMPACT MINDS
Active
Other names
IMPACT MINDS
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ASHANTI MENDHEIM (PRESIDENT)
(469) 518-3081
Entity
Organization
Contact information
Practice address
9535 FOREST LN STE 119, DALLAS, TX 75243-6120
(469) 518-3081
Mailing address
9535 FOREST LN STE 119, DALLAS, TX 75243-6120
(469) 518-3081
Taxonomy
Speciality
Code
Description
License number
State
251G00000X
Community Based Hospice Care Agency
—
—
283Q00000X
Psychiatric Hospital
—
—
310400000X
Assisted Living Facility
Primary
—
—
3104A0625X
Assisted Living Facility (Mental Illness)
—
—
3104A0630X
Assisted Living Facility (Behavioral Disturbances)
—
—
310500000X
Mental Illness Intermediate Care Facility
—
—
311Z00000X
Custodial Care Facility
—
—
311ZA0620X
Adult Care Home Facility
—
—
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
—
—
320700000X
Physical Disabilities Residential Treatment Facility
—
—
320800000X
Mental Illness Community Based Residential Treatment Facility
—
—
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
—
—
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
—
—
324500000X
Substance Abuse Rehabilitation Facility
—
—
3245S0500X
Children's Substance Abuse Rehabilitation Facility
—
—
Other
Enumeration date
07/18/2023
Last updated
07/18/2023
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