Provider Demographics
NPI:1033941372
Name:HEALTHY MINDS
Entity type:Organization
Organization Name:HEALTHY MINDS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TONYA
Authorized Official - Middle Name:SHANTEL
Authorized Official - Last Name:ESCOBAR
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:707-506-0433
Mailing Address - Street 1:15861 HIGHWAY 101 S
Mailing Address - Street 2:
Mailing Address - City:BROOKINGS
Mailing Address - State:OR
Mailing Address - Zip Code:97415-8515
Mailing Address - Country:US
Mailing Address - Phone:707-506-0433
Mailing Address - Fax:707-240-0090
Practice Address - Street 1:15861 HIGHWAY 101 S
Practice Address - Street 2:
Practice Address - City:BROOKINGS
Practice Address - State:OR
Practice Address - Zip Code:97415-8515
Practice Address - Country:US
Practice Address - Phone:707-506-0433
Practice Address - Fax:707-240-0090
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-15
Last Update Date:2024-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental HealthGroup - Multi-Specialty