MEDICARE: MIND & BODY WELLNESS CENTER, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number	:	1740977792
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MIND & BODY WELLNESS CENTER, LLC

Provider Business Mailing Address
First Line	:	450 BENTON RD STE F
Second Line	:
City	:	BOSSIER CITY
State	:	LA
Zip	:	71111-4749
Country	:	US
Telephone Number	:	318-584-0172
Fax Number	:

Provider Business Practice Location Address
First Line	:	450 BENTON RD STE F
Second Line	:
City	:	BOSSIER CITY
State	:	LA
Zip	:	71111-4749
Country	:	US
Telephone Number	:	318-584-0172
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MRS. DEANGELA KACHAN FRANCIS-JOHNSON
Credential	:	MSN, FNP-C, PMHNP-BC
Telephone Number	:	318-584-0172

Provider Enumeration Date	:	04/20/2023
Last Update Date	:	04/07/2026

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