| 1derfull Minds, Inc. | |
|
631 Cresent Dr Desoto TX 75115-8017 | |
| (469) 235-2390 | |
| (972) 637-7576 |
| Full Name | 1derfull Minds, Inc. |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 631 Cresent Dr, Desoto, Texas |
| Authorized Official Name and Position | Ella Marie Miles (PRESIDENT/PROGRAM MANAGER) |
| Authorized Official Contact | 4692352390 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| 1derfull Minds, Inc. 631 Cresent Dr Desoto TX 75115-8017 Ph: (469) 235-2390 | 1derfull Minds, Inc. 631 Cresent Dr Desoto TX 75115-8017 Ph: (469) 235-2390 |
| NPI Number | 1487318671 |
|---|---|
| Provider Enumeration Date | 10/25/2021 |
| Last Update Date | 09/29/2023 |
| Certification Date | 09/29/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487318671 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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