Active NPI
Impact Minds
- Assisted Living Facility
- Dallas, TX
National Provider Identifier
1740969567
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Assisted Living Facility
- Legal business name
- IMPACT MINDS
- Practice address
- 9535 Forest LN Ste 119
Dallas, TX 75243-6120 - Phone
- (469) 518-3081
- NPI assigned
- Jul 18, 2023
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mrs. Ashanti Mendheim
- Title
- President
- Phone
- (469) 518-3081
Specialties & licenses 15
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community Based Hospice Care Agency | 251G00000X | |||
| Psychiatric Hospital | 283Q00000X | |||
| Assisted Living Facility | 310400000X | Primary | ||
| Assisted Living Facility (Mental Illness) | 3104A0625X | |||
| Assisted Living Facility (Behavioral Disturbances) | 3104A0630X | |||
| Mental Illness Intermediate Care Facility | 310500000X | |||
| Custodial Care Facility | 311Z00000X | |||
| Adult Care Home Facility | 311ZA0620X | |||
| Intellectual and/or Developmental Disabilities Residential Treatment Facility | 320600000X | |||
| Physical Disabilities Residential Treatment Facility | 320700000X | |||
| Mental Illness Community Based Residential Treatment Facility | 320800000X | |||
| Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility | 320900000X | |||
| Emotionally Disturbed Childrens' Residential Treatment Facility | 322D00000X | |||
| Substance Abuse Rehabilitation Facility | 324500000X | |||
| Children's Substance Abuse Rehabilitation Facility | 3245S0500X |
Addresses
Primary practice location
9535 Forest LN Ste 119
Dallas, TX 75243-6120
Mailing address
9535 Forest LN Ste 119
Dallas, TX 75243-6120
Phone (469) 518-3081
Other names 1
- IMPACT MINDS
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1689638400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1689638400000",
"number": "1740969567",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9535 FOREST LN STE 119",
"city": "DALLAS",
"state": "TX",
"postal_code": "752436120",
"telephone_number": "469-518-3081"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9535 FOREST LN STE 119",
"city": "DALLAS",
"state": "TX",
"postal_code": "752436120",
"telephone_number": "469-518-3081"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "IMPACT MINDS",
"organizational_subpart": "NO",
"enumeration_date": "2023-07-18",
"last_updated": "2023-07-18",
"certification_date": "2023-07-18",
"status": "A",
"authorized_official_last_name": "MENDHEIM",
"authorized_official_first_name": "ASHANTI",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "469-518-3081",
"authorized_official_name_prefix": "Mrs."
},
"taxonomies": [
{
"code": "251G00000X",
"taxonomy_group": "",
"desc": "Hospice Care, Community Based",
"state": null,
"license": null,
"primary": false
},
{
"code": "283Q00000X",
"taxonomy_group": "",
"desc": "Psychiatric Hospital",
"state": null,
"license": null,
"primary": false
},
{
"code": "310400000X",
"taxonomy_group": "",
"desc": "Assisted Living Facility",
"state": null,
"license": null,
"primary": true
},
{
"code": "3104A0625X",
"taxonomy_group": "",
"desc": "Assisted Living Facility, Assisted Living, Mental Illness",
"state": null,
"license": null,
"primary": false
},
{
"code": "3104A0630X",
"taxonomy_group": "",
"desc": "Assisted Living Facility, Assisted Living, Behavioral Disturbances",
"state": null,
"license": null,
"primary": false
},
{
"code": "310500000X",
"taxonomy_group": "",
"desc": "Intermediate Care Facility, Mental Illness",
"state": null,
"license": null,
"primary": false
},
{
"code": "311Z00000X",
"taxonomy_group": "",
"desc": "Custodial Care Facility",
"state": null,
"license": null,
"primary": false
},
{
"code": "311ZA0620X",
"taxonomy_group": "",
"desc": "Custodial Care Facility, Adult Care Home",
"state": null,
"license": null,
"primary": false
},
{
"code": "320600000X",
"taxonomy_group": "",
"desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
"state": null,
"license": null,
"primary": false
},
{
"code": "320700000X",
"taxonomy_group": "",
"desc": "Residential Treatment Facility, Physical Disabilities",
"state": null,
"license": null,
"primary": false
},
{
"code": "320800000X",
"taxonomy_group": "",
"desc": "Community Based Residential Treatment Facility, Mental Illness",
"state": null,
"license": null,
"primary": false
},
{
"code": "320900000X",
"taxonomy_group": "",
"desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
"state": null,
"license": null,
"primary": false
},
{
"code": "322D00000X",
"taxonomy_group": "",
"desc": "Residential Treatment Facility, Emotionally Disturbed Children",
"state": null,
"license": null,
"primary": false
},
{
"code": "324500000X",
"taxonomy_group": "",
"desc": "Substance Abuse Rehabilitation Facility",
"state": null,
"license": null,
"primary": false
},
{
"code": "3245S0500X",
"taxonomy_group": "",
"desc": "Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "IMPACT MINDS",
"code": "4",
"type": "Former Legal Business Name"
}
]
}Other providers in Dallas, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.