Provider Demographics
NPI:1861139370
Name:CHANGING MINDS INC
Entity type:Organization
Organization Name:CHANGING MINDS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:TARA
Authorized Official - Middle Name:
Authorized Official - Last Name:BROOKS
Authorized Official - Suffix:
Authorized Official - Credentials:BACHELORS OF SW
Authorized Official - Phone:901-281-3425
Mailing Address - Street 1:5417 EAGLE BEAD CV
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38125-4305
Mailing Address - Country:US
Mailing Address - Phone:901-281-3425
Mailing Address - Fax:
Practice Address - Street 1:2333 CLIFFDALE CV
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38127-3514
Practice Address - Country:US
Practice Address - Phone:901-281-3425
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-16
Last Update Date:2022-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home
No251T00000XAgenciesProgram of All-Inclusive Care for the Elderly (PACE) Provider Organization
No310500000XNursing & Custodial Care FacilitiesIntermediate Care Facility, Mental Illness