Provider Demographics
NPI:1285350330
Name:HEALTHY MIND HEALTHY BODY
Entity type:Organization
Organization Name:HEALTHY MIND HEALTHY BODY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LLP
Authorized Official - Prefix:
Authorized Official - First Name:LOUISE
Authorized Official - Middle Name:
Authorized Official - Last Name:LANGDON
Authorized Official - Suffix:
Authorized Official - Credentials:LLP
Authorized Official - Phone:734-709-2628
Mailing Address - Street 1:114 9TH ST
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48103-4202
Mailing Address - Country:US
Mailing Address - Phone:734-709-2628
Mailing Address - Fax:
Practice Address - Street 1:114 9TH ST
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48103-4202
Practice Address - Country:US
Practice Address - Phone:734-709-2628
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-19
Last Update Date:2022-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounselingGroup - Single Specialty