OrganizationActive
Ageless Minds LLC
NPI 1104769611 · Psychiatric/Mental Health Clinical Nurse Specialist · Indianapolis, IN
Provider details
- NPI number
- 1104769611
- Entity type
- Organization
- Primary specialty
- Psychiatric/Mental Health Clinical Nurse SpecialistPhysician Assistants & Advanced Practice Nursing Providers
- Authorized official
- Queela Tadoum, Owner
Practice location
9165 Otis Ave Ste 164
Indianapolis, IN 46216-2312
Phone: (317) 930-1557
Mailing address
9165 Otis Ave Ste 164
Indianapolis, IN 46216-2312
Registry dates
- Enumerated
- 2026-04-10
- Last updated
- 2026-04-10
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.