NPIMap

Organization Active NPI

Mindful Growth Foundation

Doing business as Mindful Growth Foundation #2

  • Mental Illness Community Based Residential Treatment Facility
  • Los Angeles, CA
National Provider Identifier
1952989923
Registry record updated Apr 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X
Legal business name
MINDFUL GROWTH FOUNDATION
Doing business as
Mindful Growth Foundation #2
Practice address
1811 W 41St Dr
Los Angeles, CA 90062-1517
Phone
(323) 348-4615
Fax
(323) 983-4212
NPI assigned
Mar 31, 2021
Last updated
Apr 14, 2021By the provider in NPPES
Organization subpart
Yes
Parent organization
MINDFUL GROWTH FOUNDATIONAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 14, 2021

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

Authorized official

Name
Miss Jasmine Monique Sampson, MSW/MPHNPI 1831662527
Title
Director
Phone
(323) 590-9813

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Illness Community Based Residential Treatment Facility 320800000X NU Primary

Addresses

Primary practice location

1811 W 41St Dr
Los Angeles, CA 90062-1517

Mailing address

1811 W 41St Dr
Los Angeles, CA 90062-1517
Phone (323) 348-4615

Other names 1

  • Mindful Growth Foundation #2 Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Mindful Growth Foundation8 organizations share this tax ID, including this one
Part of
Mindful Growth Foundation

Other organizations with this tax ID 7

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

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 10

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.

NPI Registry JSON

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

{
    "created_epoch": "1617148800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1618358400000",
    "number": "1952989923",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1811 W 41ST DR",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900621517",
            "telephone_number": "323-348-4615",
            "fax_number": "323-983-4212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1811 W 41ST DR",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900621517",
            "telephone_number": "323-348-4615",
            "fax_number": "323-983-4212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINDFUL GROWTH FOUNDATION",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MINDFUL GROWTH FOUNDATION",
        "enumeration_date": "2021-03-31",
        "last_updated": "2021-04-14",
        "certification_date": "2021-04-14",
        "status": "A",
        "authorized_official_last_name": "SAMPSON",
        "authorized_official_first_name": "JASMINE",
        "authorized_official_middle_name": "MONIQUE",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "323-590-9813",
        "authorized_official_name_prefix": "Miss",
        "authorized_official_credential": "MSW/MPH"
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mindful Growth Foundation #2",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2021; 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.