Provider Demographics
NPI:1154746311
Name:CLEAR MINDS LLC
Entity type:Organization
Organization Name:CLEAR MINDS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NASTAZIA
Authorized Official - Middle Name:A
Authorized Official - Last Name:GUY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-445-5466
Mailing Address - Street 1:4837 FIESTA LAKES ST
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89130-2087
Mailing Address - Country:US
Mailing Address - Phone:702-708-0973
Mailing Address - Fax:
Practice Address - Street 1:4837 FIESTA LAKES ST
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89130-2087
Practice Address - Country:US
Practice Address - Phone:702-708-0973
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-25
Last Update Date:2014-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV251S00000XMedicaid