Authentic Minds LLC

Primary specialty

Child Intellectual and/or Developmental Disabilities Respite CareTaxonomy code 385HR2060X

Legal business name

AUTHENTIC MINDS LLC

Practice address

718 Baxter Avenue S
Lehigh Acres, FL 33974

Phone

(239) 271-5909

NPI assigned

Aug 31, 2017

Organization subpart

No

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

Authorized official

Name

Shiquitta Mathis

Title

Administrator

Phone

(239) 271-5909

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1504137600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1659899565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "718 BAXTER AVE S",
            "city": "LEHIGH ACRES",
            "state": "FL",
            "postal_code": "339749747",
            "telephone_number": "239-271-5909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "718 BAXTER AVENUE S",
            "city": "LEHIGH ACRES",
            "state": "FL",
            "postal_code": "33974",
            "telephone_number": "239-271-5909"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AUTHENTIC MINDS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-08-31",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "MATHIS",
        "authorized_official_first_name": "SHIQUITTA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "239-271-5909"
    },
    "taxonomies": [
        {
            "code": "385HR2060X",
            "taxonomy_group": "",
            "desc": "Respite Care, Respite Care, Intellectual and/or Developmental Disabilities, Child",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Child Intellectual and/or Developmental Disabilities Respite Care in Lehigh Acres, FL
• Providers in Lehigh Acres, FL by specialty
• Child Intellectual and/or Developmental Disabilities Respite Care in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 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.