| Vigilant Mindz | |
|
1801 E Broad St Richmond VA 23223-6974 | |
| (804) 306-0163 | |
| Not Available |
| Full Name | Vigilant Mindz |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 1801 E Broad St, Richmond, Virginia |
| Authorized Official Name and Position | Shawn Lamont Minter (OWNER) |
| Authorized Official Contact | 8043060163 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Vigilant Mindz Po Box 945 Richmond VA 23218-0945 Ph: (804) 306-0163 | Vigilant Mindz 1801 E Broad St Richmond VA 23223-6974 Ph: (804) 306-0163 |
| NPI Number | 1962861641 |
|---|---|
| Provider Enumeration Date | 02/23/2016 |
| Last Update Date | 02/23/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962861641 | NPI | - | NPPES |
| 1801041132 | Medicaid | VA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 1152 (Virginia) | Primary |
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