# HEALING MINDS OUTREACH, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1699555128
- **Authorized official:** BRODRICK WATERS (OWNER)
- **Authorized official phone:** (941) 250-8643

## Contact information

- **Practice address:** 12300 RESERVE MANOR CIR APT 202, CHESTER, VA 23831-3764
- **Practice address phone:** (941) 250-8643
- **Mailing address:** 12300 RESERVE MANOR CIR APT 202, CHESTER, VA 23831-3764
- **Mailing address phone:** (941) 250-8643

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 171M00000X | Case Manager/Care Coordinator | — | NULL | Yes |
| 171M00000X | Case Manager/Care Coordinator | — | — | Yes |

## Other

- **Enumeration date:** 10/02/2023
- **Last updated:** 10/02/2023