| Mindful Behavioral | |
|
3255 Landmark Dr North Charleston SC 29418-8461 | |
| (843) 864-1661 | |
| (843) 628-1020 |
| Full Name | Mindful Behavioral |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 3255 Landmark Dr, North Charleston, South Carolina |
| Authorized Official Name and Position | Jomoyatta Akila Proctor (PRESIDENT) |
| Authorized Official Contact | 9196970767 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mindful Behavioral 3255 Landmark Dr North Charleston SC 29418-8461 Ph: (843) 864-1661 | Mindful Behavioral 3255 Landmark Dr North Charleston SC 29418-8461 Ph: (843) 864-1661 |
| NPI Number | 1891108320 |
|---|---|
| Provider Enumeration Date | 06/02/2014 |
| Last Update Date | 06/02/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891108320 | NPI | - | NPPES |
| 159 BHS | Medicaid | SC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 159 BHS (South Carolina) | Primary |
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