Provider Demographics
NPI:1386332492
Name:PRECISE MIND BEHAVIORAL LLC
Entity type:Organization
Organization Name:PRECISE MIND BEHAVIORAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AR/ BILLING ACCOUNT MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CRYSTAL
Authorized Official - Middle Name:
Authorized Official - Last Name:THOMPSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:307-231-5472
Mailing Address - Street 1:PO BOX 687 PMB 175
Mailing Address - Street 2:
Mailing Address - City:PINEDALE
Mailing Address - State:WY
Mailing Address - Zip Code:82941
Mailing Address - Country:US
Mailing Address - Phone:307-231-5472
Mailing Address - Fax:
Practice Address - Street 1:219 E PINE ST STE 203
Practice Address - Street 2:
Practice Address - City:PINEDALE
Practice Address - State:WY
Practice Address - Zip Code:82941-5420
Practice Address - Country:US
Practice Address - Phone:307-231-5472
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-26
Last Update Date:2023-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)