| Mindful Heart Organization Inc | |
|
5897 Little Leaf Ct Milton FL 32570-3501 | |
| (850) 490-7829 | |
| Not Available |
| Full Name | Mindful Heart Organization Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 5897 Little Leaf Ct, Milton, Florida |
| Authorized Official Name and Position | Marc D Whittlesay (OWNER) |
| Authorized Official Contact | 8504907829 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mindful Heart Organization Inc 5897 Little Leaf Ct Milton FL 32570-3501 Ph: (850) 490-7829 | Mindful Heart Organization Inc 5897 Little Leaf Ct Milton FL 32570-3501 Ph: (850) 490-7829 |
| NPI Number | 1871240317 |
|---|---|
| Provider Enumeration Date | 03/04/2022 |
| Last Update Date | 03/04/2022 |
| Certification Date | 03/04/2022 |
| Medicare PECOS PAC ID | 4385172238 |
|---|---|
| Medicare Enrollment ID | O20250107000210 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871240317 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Marc Daniel Whittlesay |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1124772413 PECOS PAC ID: 5294263141 Enrollment ID: I20250107000249 |
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