Healthcare Provider Details

I. General information

NPI: 1043114903
Provider Name (Legal Business Name): HEALTH OF MIND LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/05/2026
Last Update Date: 10/05/2026
Certification Date: 10/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

612 1ST ST NW
ALBUQUERQUE NM
87102-2306
US

IV. Provider business mailing address

612 1ST ST NW
ALBUQUERQUE NM
87102-2306
US

V. Phone/Fax

Practice location:
  • Phone: 732-523-4057
  • Fax:
Mailing address:
  • Phone: 732-523-4057
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number StateNULL

VIII. Authorized Official

Name: UCHENNA QUARTEY
Title or Position: OWNER
Credential:
Phone: 210-570-2534