Organization Name: | BODY & MIND, LLC |
NPI Number: | 1033593967 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | HAMLET R HASSAN (PRESIDENT) |
Mailing Address: | 4886 Lake Worth Rd Suite C Greenacres |
State: | FL US |
Postal Code: | 334638725 |
Phone Number: | 9542133702 |
Fax Number: | |
NPI Enumeration Date: | 07/09/2015 |
NPI Last Update Date: | 07/09/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |