| Elemental Body & Mind | |
|
131 E Court Ave Ste 100 Jeffersonville IN 47130-3600 | |
| (812) 408-3674 | |
| (812) 407-8126 |
| Full Name | Elemental Body & Mind |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 131 E Court Ave Ste 100, Jeffersonville, Indiana |
| Authorized Official Name and Position | James Haven (OWNER/PARTNER) |
| Authorized Official Contact | 5026491387 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Elemental Body & Mind 131 E Court Ave Ste 100 Jeffersonville IN 47130-3600 Ph: (812) 408-3674 | Elemental Body & Mind 131 E Court Ave Ste 100 Jeffersonville IN 47130-3600 Ph: (812) 408-3674 |
| NPI Number | 1518782663 |
|---|---|
| Provider Enumeration Date | 11/22/2024 |
| Last Update Date | 11/22/2024 |
| Certification Date | 11/22/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518782663 | NPI | - | NPPES |
| 1841852118 | Medicaid | IN | |
| 1376258418 | Medicaid | IN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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