Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Mental Health (Including Community Mental Health Center) |
261QM0801X | B4[14] | Community Mental Health Center | |
Psychiatric/Mental Health |
363LP0808X | 50 | Nurse Practitioner | |
Psychiatry |
2084P0800X | 26 | Physician/Psychiatry |
| NPI Number | 1255132262 |
| LBN Legal business name | A SUSTAINABLE MIND, LLP |
| Authorized official | MEAGAN HOOVER - (OWNER) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | 03/24/2025 |
| Last updated | 03/24/2025 - More than a year ago |
| Identifiers | n/a |
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