Healthcare Provider Details
I. General information
NPI: 1730697277
Provider Name (Legal Business Name): HEALTHY MIND FOREVER
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/18/2018
Last Update Date: 01/18/2018
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
8050 W JUDGE PEREZ DR STE 3500
CHALMETTE LA
70043-1742
US
IV. Provider business mailing address
8050 W JUDGE PEREZ DR STE 3500
CHALMETTE LA
70043-1742
US
V. Phone/Fax
- Phone: 504-322-7088
- Fax: 504-208-3270
- Phone: 504-322-7088
- Fax: 504-208-3270
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QM0850X |
| Taxonomy | Adult Mental Health Clinic/Center |
| License Number | MD.204388 |
| License Number State | LA |
VIII. Authorized Official
Name:
JOSEPHINE
SABHARWAL
Title or Position: MD
Credential:
Phone: 504-322-7088