Healthcare Provider Details

I. General information

NPI: 1962002931
Provider Name (Legal Business Name): MIND OVER MOOD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/29/2020
Last Update Date: 09/23/2026
Certification Date: 09/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

115 CARLOS DRIVE
GARYSBURG NC
27831
US

IV. Provider business mailing address

115 CARLOS DR
GARYSBURG NC
27831-6200
US

V. Phone/Fax

Practice location:
  • Phone: 252-365-7081
  • Fax:
Mailing address:
  • Phone: 252-365-7081
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code320800000X
TaxonomyMental Illness Community Based Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: REKETER LYNETTE BARBER
Title or Position: CEO/ FOUNDER
Credential:
Phone: 252-365-7081