Healthcare Provider Details

I. General information

NPI: 1316873169
Provider Name (Legal Business Name): A MINDFUL TRANSFORMATION, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/19/2026
Last Update Date: 06/19/2026
Certification Date: 06/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6447 SW 117TH STREET RD
OCALA FL
34476-9620
US

IV. Provider business mailing address

6447 SW 117TH STREET RD
OCALA FL
34476-9620
US

V. Phone/Fax

Practice location:
  • Phone: 352-679-2292
  • Fax:
Mailing address:
  • Phone: 352-679-2292
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. STEVEN J DALE
Title or Position: CFO
Credential:
Phone: 352-679-2292