NPIMap

Organization Active NPI

Mind & Mane

  • Adult Mental Health Clinic/Center
  • Wake Forest, NC
National Provider Identifier
1316673163
Registry record updated Jul 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X
Legal business name
MIND & MANE
Practice address
3664 Genesis LN
Wake Forest, NC 27587-6088
Phone
(443) 538-7275
NPI assigned
Jul 25, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Zean King
Title
Ceo
Phone
(443) 949-6710

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Mental Health Clinic/Center 261QM0850X Primary
Adolescent and Children Mental Health Clinic/Center 261QM0855X

Addresses

Primary practice location

3664 Genesis LN
Wake Forest, NC 27587-6088

Mailing address

3664 Genesis LN
Wake Forest, NC 27587-6088
Phone (443) 538-7275

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL mymindandmain@gmail.com

National Provider Directory

National Provider Directory
Tax ID family
Mind Mane2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1658707200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658707200000",
    "number": "1316673163",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3664 GENESIS LN",
            "city": "WAKE FOREST",
            "state": "NC",
            "postal_code": "275876088",
            "telephone_number": "443-538-7275"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3664 GENESIS LN",
            "city": "WAKE FOREST",
            "state": "NC",
            "postal_code": "275876088",
            "telephone_number": "443-538-7275"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIND & MANE",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-07-25",
        "last_updated": "2022-07-25",
        "certification_date": "2022-07-14",
        "status": "A",
        "authorized_official_last_name": "KING",
        "authorized_official_first_name": "ZEAN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "443-949-6710",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "mymindandmain@gmail.com",
            "affiliation": "N",
            "address_1": "3664 Genesis Ln",
            "city": "Wake Forest",
            "state": "NC",
            "country_code": "US",
            "postal_code": "275876088",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Wake Forest, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.