Provider Demographics
NPI:1972330447
Name:MINDSET WELLNESS CENTER
Entity type:Organization
Organization Name:MINDSET WELLNESS CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:OLUBUNMI
Authorized Official - Middle Name:
Authorized Official - Last Name:SALAMI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-241-6000
Mailing Address - Street 1:4920 NIAGARA RD STE 102
Mailing Address - Street 2:
Mailing Address - City:COLLEGE PARK
Mailing Address - State:MD
Mailing Address - Zip Code:20740-1103
Mailing Address - Country:US
Mailing Address - Phone:301-241-6000
Mailing Address - Fax:301-747-7400
Practice Address - Street 1:4920 NIAGARA RD STE 102
Practice Address - Street 2:
Practice Address - City:COLLEGE PARK
Practice Address - State:MD
Practice Address - Zip Code:20740-1103
Practice Address - Country:US
Practice Address - Phone:301-241-6000
Practice Address - Fax:301-747-7400
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-18
Last Update Date:2024-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty
No261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health
No364SP0813XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health, GeropsychiatricGroup - Single Specialty