| NPI | 1538717723 |
|---|---|
| Doing Business As | MINDOULA HEALTH, INC. |
| Entity Type | Organization |
| Authorized Contact | GLENDA WRENN GORDON President 888-879-9786 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry |
| Additional Taxonomies | 101YP2500X Counselor, Professional |
| 1041C0700X Social Worker, Clinical | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health | |
| Enumeration Date | 2019-08-30 |
| Last Update Date | 2024-08-22 |