Provider Demographics
NPI:1104607258
Name:CARING MINDS WELLNESS CENTER
Entity type:Organization
Organization Name:CARING MINDS WELLNESS CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:CRYSTAL
Authorized Official - Middle Name:ANTWANETTE
Authorized Official - Last Name:KINGCADE
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:843-676-5461
Mailing Address - Street 1:PO BOX 7700
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:SC
Mailing Address - Zip Code:29502-7700
Mailing Address - Country:US
Mailing Address - Phone:843-676-5461
Mailing Address - Fax:
Practice Address - Street 1:2301 GADWELL PT
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:SC
Practice Address - Zip Code:29501-4287
Practice Address - Country:US
Practice Address - Phone:843-676-5461
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-12
Last Update Date:2023-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty