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AGELESS MINDS LLC
NPI 1104769611
Clinical Nurse Specialist - Psychiatric/Mental Health in Indianapolis, IN

Active since April 10, 2026
9165 OTIS AVE STE 164, INDIANAPOLIS, IN 46216(317) 930-1557 Get Directions Write a Review

NPPES record last updated: April 10, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Ageless Minds Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

AGELESS MINDS LLC (NPI 1104769611) is a healthcare organization registered as a psychiatric/mental health in Indianapolis, Indiana and active in the NPI registry since April 2026. The organization lists Queela Tadoum, Owner, as its authorized official.

NPPES Registry Identity

NPI1104769611
Entity TypeOrganization
Primary Taxonomy364SP0808X
Legal Business NameAGELESS MINDS LLC
Location Address9165 OTIS AVE STE 164Indianapolis, IN 46216-2312
Mailing Address9165 Otis Ave Ste 164Indianapolis, IN 46216-2312
Phone(317) 930-1557
Organization SubpartNo
Authorized OfficialQueela TadoumOwner · (317) 930-1557
Enumeration DateApril 10, 2026
NPPES CertifiedApril 10, 2026
✔ NPI 1104769611 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinical Nurse Specialist · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code364SP0808X
9165 OTIS AVE STE 164, Indianapolis, IN 46216
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Ageless Minds LLC's NPI number?

The NPI number for Ageless Minds LLC is 1104769611. It was assigned to this organization in the NPPES registry on April 10, 2026.

Where is Ageless Minds LLC located?

Ageless Minds LLC is located at 9165 Otis Ave Ste 164, Indianapolis, IN 46216. The listed phone number is (317) 930-1557.

What is Ageless Minds LLC's specialty?

The primary specialty registered for this NPI is Clinical Nurse Specialist, specializing in Psychiatric/Mental Health, with taxonomy code 364SP0808X.

When was this NPI record last updated?

The NPPES record for Ageless Minds LLC was last updated on April 10, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.