| Mind Body & Soul Behavioral Health And Wellness Llc | |
|
1365 Ebenezer Rd Rock Hill SC 29732-2336 | |
| (803) 708-7556 | |
| (803) 708-7801 |
| Full Name | Mind Body & Soul Behavioral Health And Wellness Llc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 1365 Ebenezer Rd, Rock Hill, South Carolina |
| Authorized Official Name and Position | Shukairo M Baker (CEO) |
| Authorized Official Contact | 9803098508 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mind Body & Soul Behavioral Health And Wellness Llc 1365 Ebenezer Rd Rock Hill SC 29732-2336 Ph: (803) 708-7556 | Mind Body & Soul Behavioral Health And Wellness Llc 1365 Ebenezer Rd Rock Hill SC 29732-2336 Ph: (803) 708-7556 |
| NPI Number | 1154954634 |
|---|---|
| Provider Enumeration Date | 02/12/2020 |
| Last Update Date | 02/12/2020 |
| Certification Date | 02/12/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154954634 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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