National Provider Identifier Database

IMPACT MINDS
Assisted Living Facility

A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being.

Contact Information

IMPACT MINDS
9535 FOREST LN STE 119
DALLAS, TX  75243-6120
Phone: 469-518-3081
Fax:
Website:
Specialty Taxonomy Code
* Assisted Living Facility 310400000X
Adult Care Home 311ZA0620X
Assisted Living, Behavioral Disturbances 3104A0630X
Assisted Living, Mental Illness 3104A0625X
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities 320900000X
Community Based Residential Treatment Facility, Mental Illness 320800000X
Custodial Care Facility 311Z00000X
Hospice Care, Community Based 251G00000X
Intermediate Care, Mental Illness 310500000X
Psychiatric Hospital 283Q00000X
Residential Treatment Facility, Emotionally Disturbed Children 322D00000X
Residential Treatment Facility, Intellectual and/or Developmental Disabilities 320600000X
Residential Treatment Facility, Physical Disabilities 320700000X
Substance Abuse Disorder Rehabilitation Facility 324500000X
Substance Abuse Treatment, Children 3245S0500X

* Indicates primary specialty

NPI Profile & details for IMPACT MINDS

NPI Number 1740969567
Legal business name
LBN		 IMPACT MINDS
Authorized official ASHANTI MENDHEIM - (PRESIDENT)
Entity Organization
Organization subpart No
Enumeration date 07/18/2023
Last updated 07/18/2023 - About 3 years ago
Sole proprietor1 Not specified
Identifiers n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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