Organization
MIND & BODY AT HOME LIVING SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MYSTI NICHELE NICHOLS MSW (OWNER/CEO)
(757) 774-3360
Entity
Organization
Contact information
Practice address
8406 SHEPHERDS WATCH DR, CHESTERFIELD, VA 23832-7871
(757) 774-3360
Mailing address
8406 SHEPHERDS WATCH DR, CHESTERFIELD, VA 23832-7871
(757) 774-3360
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
—
—
Other
Enumeration date
08/29/2019
Last updated
08/29/2019
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