| Active Mindz, Llc. | |
|
205 River Way Court Apt. 202 Owings Mills MD 21117 | |
| (410) 967-6873 | |
| Not Available |
| Full Name | Active Mindz, Llc. |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 205 River Way Court, Owings Mills, Maryland |
| Authorized Official Name and Position | Brian Wilson (CLINICAL THERAPIST) |
| Authorized Official Contact | 4109676873 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Active Mindz, Llc. 205 River Way Court Apt. 202 Owings Mills MD 21117 Ph: (410) 967-6873 | Active Mindz, Llc. 205 River Way Court Apt. 202 Owings Mills MD 21117 Ph: (410) 967-6873 |
| NPI Number | 1164138285 |
|---|---|
| Provider Enumeration Date | 01/24/2023 |
| Last Update Date | 01/24/2023 |
| Certification Date | 01/24/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164138285 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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