| NPI | 1790542611 |
|---|---|
| Doing Business As | MYNDFIT |
| Entity Type | Organization |
| Authorized Contact | CARLTON THOMAS FAIRLEY Owner/Chief Executive Officer 210-665-3330 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 251S00000X Community/Behavioral Health | |
| 252Y00000X Early Intervention Provider Agency | |
| 253Z00000X In Home Supportive Care | |
| 305R00000X Preferred Provider Organization | |
| 315P00000X Intermediate Care Facility, Intellectual Disabilities | |
| Enumeration Date | 2024-03-06 |
| Last Update Date | 2024-03-20 |