Healthcare Provider Details

I. General information

NPI: 1013786987
Provider Name (Legal Business Name): HEALTHY MIND FOUNDATION AFRICA LIMITED
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/20/2023
Last Update Date: 01/09/2024
Certification Date: 01/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5505 1/2 REISTERSTOWN RD
BALTIMORE MD
21215-4406
US

IV. Provider business mailing address

8101 SANDY SPRING RD STE 300-W29
LAUREL MD
20707-3596
US

V. Phone/Fax

Practice location:
  • Phone: 443-927-6186
  • Fax: 667-803-0305
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: GERALD GWAIN CHIA
Title or Position: DIRECTOR
Credential:
Phone: 202-313-7283