Provider Demographics
NPI:1538558929
Name:HEALTHY MIND BODY & SPIRIT LLC.
Entity type:Organization
Organization Name:HEALTHY MIND BODY & SPIRIT LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BST
Authorized Official - Prefix:MISS
Authorized Official - First Name:AMIRA
Authorized Official - Middle Name:FRANSO
Authorized Official - Last Name:TOMA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-810-1109
Mailing Address - Street 1:7739 CASCADE BLUFFS CT
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89123-0460
Mailing Address - Country:US
Mailing Address - Phone:702-810-1109
Mailing Address - Fax:
Practice Address - Street 1:7739 CASCADE BLUFFS CT
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89123
Practice Address - Country:US
Practice Address - Phone:702-810-1109
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-22
Last Update Date:2015-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health