Organization
MINDFUL SOUL THERAPEUTIC SOLUTIONS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
IRIS M. BLANCHARD LPC, LICDC, SAP (CEO)
(937) 626-6481
Entity
Organization
Contact information
Practice address
130 W WENGER RD, ENGLEWOOD, OH 45322-2760
(937) 626-6481
Mailing address
329 IMOGENE RD, DAYTON, OH 45405-5208
(937) 626-6481
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
3245S0500X
Children's Substance Abuse Rehabilitation Facility
—
—
Other
Enumeration date
07/26/2023
Last updated
08/14/2023
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