Provider Demographics
NPI:1053910158
Name:OPEN MIND MENTAL HEALTH INC
Entity type:Organization
Organization Name:OPEN MIND MENTAL HEALTH INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:CRAIG
Authorized Official - Middle Name:
Authorized Official - Last Name:BEACH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:619-940-0159
Mailing Address - Street 1:5241 ALZEDA DR
Mailing Address - Street 2:
Mailing Address - City:LA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:91941-5726
Mailing Address - Country:US
Mailing Address - Phone:619-940-0042
Mailing Address - Fax:
Practice Address - Street 1:5241 ALZEDA DR
Practice Address - Street 2:
Practice Address - City:LA MESA
Practice Address - State:CA
Practice Address - Zip Code:91941-5726
Practice Address - Country:US
Practice Address - Phone:619-940-0042
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-20
Last Update Date:2020-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty