Provider Demographics
NPI:1053623926
Name:ATTENTIVE MIND CORPORATION
Entity type:Organization
Organization Name:ATTENTIVE MIND CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RACHEL
Authorized Official - Middle Name:
Authorized Official - Last Name:FLEISSNER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:701-364-9723
Mailing Address - Street 1:2902 UNIVERSITY DR S
Mailing Address - Street 2:
Mailing Address - City:FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58103-6053
Mailing Address - Country:US
Mailing Address - Phone:701-364-9723
Mailing Address - Fax:701-364-9870
Practice Address - Street 1:2902 UNIVERSITY DR S
Practice Address - Street 2:
Practice Address - City:FARGO
Practice Address - State:ND
Practice Address - Zip Code:58103-6053
Practice Address - Country:US
Practice Address - Phone:701-364-9723
Practice Address - Fax:701-364-9870
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-08
Last Update Date:2011-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND7991261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)