MEDICARE: MIND OVER MATTER SERVICES

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	261QA0600X	Adult Day Care Clinic/Center

General Provider Information

NPI Number	:	1962392795
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MIND OVER MATTER SERVICES

Provider Business Mailing Address
First Line	:	102 N 3RD AVE
Second Line	:
City	:	HOPEWELL
State	:	VA
Zip	:	23860-2636
Country	:	US
Telephone Number	:	804-401-5567
Fax Number	:

Provider Business Practice Location Address
First Line	:	2007 S SYCAMORE ST
Second Line	:
City	:	PETERSBURG
State	:	VA
Zip	:	23805-2726
Country	:	US
Telephone Number	:	804-401-5567
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	MORGAN NIKEL SPENCER
Credential	:
Telephone Number	:	804-401-5567

Provider Enumeration Date	:	07/03/2025
Last Update Date	:	07/03/2025

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Directions to “MIND OVER MATTER SERVICES ” Practice Location

Language	Start Address	Practice Location

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