Provider Type Icon

HEALTHY MIND - FULL LIFE LLC NPI 1396316915


NPI Information

NPI: 1396316915
Provider Name: HEALTHY MIND - FULL LIFE, LLC
Classification: Clinic/Center - 261QM0850X
Entity Type: Organization

Specialization: Adult Mental Health

Address:
1778 CENTURY BLVD NE STE A
ATLANTA, GA
ZIP 30345
Phone: (202) 352-5891
Get Directions

HEALTHY MIND - FULL LIFE, LLC is an adult mental health clinic center in Atlanta, GA. The provider is an entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in adults. HEALTHY MIND - FULL LIFE, LLC NPI is 1396316915. The provider is registered as an organization entity type.

The provider's business location address is:

1778 CENTURY BLVD NE STE A
ATLANTA, GA
ZIP 30345-398
Phone: (202) 352-5891

The provider's authorized official is Kendall L Blake .
The authorized official title is Owner and has the following contact phone number (202) 352-5891.

The enumeration date for this NPI number is 7/6/2021 and was last updated on 7/6/2021.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QM0850XClinic/CenterAdult Mental HealthYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.