NPIMap

Organization Active NPI

Mind Over Matter Living

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Centennial, CO
National Provider Identifier
1871240424
Registry record updated Nov 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X
Legal business name
MIND OVER MATTER LIVING
Practice address
4366 S Gibraltar St
Centennial, CO 80015-5427
Phone
(623) 336-0937
NPI assigned
Mar 3, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2022

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

Authorized official

Name
Jerome BrownNPI 1487000915
Title
Chief Executive Director/Owner
Phone
(623) 336-0937

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation CounselorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 225C00000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X Primary
HomemakerGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 376J00000X
Respite Care 385H00000X

Addresses

Primary practice location

4366 S Gibraltar St
Centennial, CO 80015-5427

Mailing address

4366 S Gibraltar St
Centennial, CO 80015-5427
Phone (623) 336-0937

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1646265600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1667347200000",
    "number": "1871240424",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4366 S GIBRALTAR ST",
            "city": "CENTENNIAL",
            "state": "CO",
            "postal_code": "800155427",
            "telephone_number": "623-336-0937"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4366 S GIBRALTAR ST",
            "city": "CENTENNIAL",
            "state": "CO",
            "postal_code": "800155427",
            "telephone_number": "623-336-0937"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIND OVER MATTER LIVING",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-03-03",
        "last_updated": "2022-11-02",
        "certification_date": "2022-11-02",
        "status": "A",
        "authorized_official_last_name": "BROWN",
        "authorized_official_first_name": "JEROME",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE DIRECTOR/OWNER",
        "authorized_official_telephone_number": "623-336-0937"
    },
    "taxonomies": [
        {
            "code": "225C00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Rehabilitation Counselor",
            "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": true
        },
        {
            "code": "376J00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Homemaker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "385H00000X",
            "taxonomy_group": "",
            "desc": "Respite Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Centennial, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 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.