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Contact Information

ICONIC MIND
102 CRABAPPLE GRV
MADISON, MS39110-7098
 Phone: 601-918-8041
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Case Manager/Care Coordinator

171M00000X
Indicates primary specialty

NPI Profile & details for ICONIC MIND

NPI # 1801430590
LBN Legal business name ICONIC MIND
Authorized official KIMBERLY HORTON - (OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 11/05/2019
Last updated 01/04/2021 - About 5 years ago
Identifiers n/a
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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