Provider Demographics
NPI:1164233763
Name:BETTERMIND WELLNESS LLC
Entity type:Organization
Organization Name:BETTERMIND WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KOMAL
Authorized Official - Middle Name:
Authorized Official - Last Name:FARRUKH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:586-495-6021
Mailing Address - Street 1:18623 LONDON DR
Mailing Address - Street 2:
Mailing Address - City:MACOMB
Mailing Address - State:MI
Mailing Address - Zip Code:48042-6216
Mailing Address - Country:US
Mailing Address - Phone:586-495-6021
Mailing Address - Fax:
Practice Address - Street 1:4879 CRYSTAL CREEK LN
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:MI
Practice Address - Zip Code:48094-4216
Practice Address - Country:US
Practice Address - Phone:586-495-6021
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-14
Last Update Date:2025-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty