Sound Mind Adc, LLC

Primary specialty

Adult Day Care Clinic/CenterTaxonomy code 261QA0600X

Legal business name

SOUND MIND ADC, LLC

Practice address

4411 Wistar Rd
Henrico, VA 23228

Phone

(804) 922-7203

NPI assigned

Jul 11, 2018

Last updated

Jul 12, 2018By 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

Dr. Ellis Henderson

Title

Owner

Phone

(804) 852-7645

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1531267200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1531353600000",
    "number": "1962988139",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4411 WISTAR RD",
            "city": "HENRICO",
            "state": "VA",
            "postal_code": "232282640",
            "telephone_number": "804-922-7203",
            "fax_number": "804-262-1576"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4411 WISTAR RD",
            "city": "HENRICO",
            "state": "VA",
            "postal_code": "23228",
            "telephone_number": "804-922-7203"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUND MIND ADC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-07-11",
        "last_updated": "2018-07-12",
        "status": "A",
        "authorized_official_last_name": "HENDERSON",
        "authorized_official_first_name": "ELLIS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "804-852-7645",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "261QA0600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Day Care",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "823153086",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Adult Day Care Clinic/Center in Henrico, VA
• Providers in Henrico, VA by specialty
• Adult Day Care Clinic/Center in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2018; 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.