Heart and Mind Healing Center Corp

Primary specialty

Comprehensive Outpatient Rehabilitation Facility (CORF)Taxonomy code 261QR0401X

Legal business name

HEART AND MIND HEALING CENTER CORP

Practice address

8399 W Oakland Park Blvd Ste a
Sunrise, FL 33351-7311

Phone

(772) 418-1156

Fax

(561) 404-1425

NPI assigned

Feb 15, 2018

Last updated

Oct 15, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Ayinde Reid, L.C.S.W.NPI 1639587769

Title

President

Phone

(561) 404-1422

Specialties & licenses 3

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1841790920. Details of each certification follow.

• CCN 104898 Comprehensive outpatient rehabilitation facility · Active · Name & address match · Details

Comprehensive outpatient rehabilitation facility certification: CCN 104898

Legal name

HEART AND MIND HEALING CENTER CORP

Certification status

Active

Provider type (POS)

Comprehensive outpatient rehabilitation facility

Participating since

Jun 29, 2021

Last certification

Jun 29, 2021

Ownership / control type

Proprietary

Facility address

8399 W Oakland PK Blvd Ste a
Sunrise, FL 33351

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Ayinde K Reid, LCSW

  • Clinical Social Worker
  • Sunrise, FL
  • NPI 1639587769
  NPD Authorized official

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

{
    "created_epoch": "1518652800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1634256000000",
    "number": "1841790920",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8399 W OAKLAND PARK BLVD STE A",
            "city": "SUNRISE",
            "state": "FL",
            "postal_code": "333517311",
            "telephone_number": "772-418-1156",
            "fax_number": "561-404-1425"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8399 W OAKLAND PARK BLVD STE A",
            "city": "SUNRISE",
            "state": "FL",
            "postal_code": "333517311",
            "telephone_number": "772-418-1156",
            "fax_number": "561-404-1425"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8395 W Oakland Park Blvd Ste C",
            "address_purpose": "LOCATION",
            "city": "Sunrise",
            "state": "FL",
            "postal_code": "333517346",
            "country_code": "US",
            "telephone_number": "561-404-1422 x103",
            "fax_number": "561-404-1425",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "HEART AND MIND HEALING CENTER CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-02-15",
        "last_updated": "2021-10-15",
        "certification_date": "2021-10-15",
        "status": "A",
        "authorized_official_last_name": "REID",
        "authorized_official_first_name": "AYINDE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "561-404-1422",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "L.C.S.W."
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QC1500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Community Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0401X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "82",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMMUNITY OUTPATIENT REHABILITATION FACILITY",
            "identifier": "104898",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Comprehensive Outpatient Rehabilitation Facility (CORF) in Sunrise, FL
• Providers in Sunrise, FL by specialty
• Comprehensive Outpatient Rehabilitation Facility (CORF) in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.