Organization
MINDOULA HEALTH INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GREGORY COUTO (SVP OPERATIONS)
(954) 650-2802
Entity
Organization
Contact information
Practice address
232 CAPITOL ST, CHARLESTON, WV 25301-2234
(888) 879-9786
Mailing address
8040 GEORGIA AVE STE 170, SILVER SPRING, MD 20910-4959
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
06/25/2020
Last updated
01/11/2024
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