Provider Demographics
NPI:1679087175
Name:MINDS FOR HEALTH LLC
Entity type:Organization
Organization Name:MINDS FOR HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JIHAN
Authorized Official - Middle Name:OMAR
Authorized Official - Last Name:ABDI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:207-332-1936
Mailing Address - Street 1:PO BOX 194
Mailing Address - Street 2:
Mailing Address - City:LEWISTON
Mailing Address - State:ME
Mailing Address - Zip Code:04243-0194
Mailing Address - Country:US
Mailing Address - Phone:207-753-2688
Mailing Address - Fax:207-753-2788
Practice Address - Street 1:15A WESTMINISTER STREET
Practice Address - Street 2:
Practice Address - City:LEWISTON
Practice Address - State:ME
Practice Address - Zip Code:04240-7235
Practice Address - Country:US
Practice Address - Phone:207-753-2688
Practice Address - Fax:207-753-2788
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-21
Last Update Date:2023-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME251B00000X, 251S00000X, 251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
No251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME=========Medicaid