Provider Demographics
NPI:1063228740
Name:EVOLVING MINDS BEHAVIORAL HEALTH, LLC.
Entity type:Organization
Organization Name:EVOLVING MINDS BEHAVIORAL HEALTH, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LEQUISHA
Authorized Official - Middle Name:
Authorized Official - Last Name:TURNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-983-3500
Mailing Address - Street 1:3136 N 57TH ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68104-3443
Mailing Address - Country:US
Mailing Address - Phone:402-983-3500
Mailing Address - Fax:
Practice Address - Street 1:7701 PACIFIC ST STE 323
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68114-5480
Practice Address - Country:US
Practice Address - Phone:402-819-9208
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-06
Last Update Date:2024-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health