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General NPI Number Information
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NPI Number | 1841790920
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Entity Type | Organization
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Legal Business Name | HEART AND MIND HEALING CENTER CORP
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Dates
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Enumeration Date | 02/15/2018
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Last Update Date | 10/15/2021
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Provider Practice Location Address
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Address Line | 8399 W OAKLAND PARK BLVD STE A
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City | SUNRISE
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State | FL
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Zip | 33351-7311
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Country | US
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Telephone | 772-418-1156
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Fax | 561-404-1425
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Provider Business Mailing Address
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Address Line | 8399 W OAKLAND PARK BLVD STE A
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City | SUNRISE
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State | FL
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Zip | 33351-7311
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Country | US
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Telephone | 772-418-1156
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Fax | 561-404-1425
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. AYINDE REID
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Credential | L.C.S.W.
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Telephone | 561-404-1422
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QC1500X
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Taxonomy Name | Community Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QR0401X
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Taxonomy Name | Comprehensive Outpatient Rehabilitation Facility (CORF)
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License Number |
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License Number State |
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