Provider Demographics
NPI:1215781026
Name:FRAME OF MIND CLINIC LLC
Entity type:Organization
Organization Name:FRAME OF MIND CLINIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:JAYSON
Authorized Official - Middle Name:
Authorized Official - Last Name:AGATON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:725-726-8216
Mailing Address - Street 1:6540 S PECOS RD STE 103A
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89120-2819
Mailing Address - Country:US
Mailing Address - Phone:725-726-8216
Mailing Address - Fax:725-726-8633
Practice Address - Street 1:6540 S PECOS RD STE 103A
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89120-2819
Practice Address - Country:US
Practice Address - Phone:725-726-8216
Practice Address - Fax:725-726-8633
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-16
Last Update Date:2025-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontologyGroup - Multi-Specialty