Provider Demographics
NPI:1285253930
Name:HEALTHY MIND SERVICES
Entity type:Organization
Organization Name:HEALTHY MIND SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:SALENA
Authorized Official - Middle Name:
Authorized Official - Last Name:PHILLIPS-BAKER
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:231-519-2354
Mailing Address - Street 1:106 S STEWART AVE
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:MI
Mailing Address - Zip Code:49412-1624
Mailing Address - Country:US
Mailing Address - Phone:231-519-2354
Mailing Address - Fax:231-422-0022
Practice Address - Street 1:106 S STEWART AVE
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:MI
Practice Address - Zip Code:49412-1624
Practice Address - Country:US
Practice Address - Phone:231-335-1718
Practice Address - Fax:231-422-0022
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-13
Last Update Date:2020-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health