Organization
RECONSTRUCTED MINDS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TERRY DANIELSON JR. (CEO)
(740) 646-2580
Entity
Organization
Contact information
Practice address
22436 SOUTHSHORE DR, LAND O LAKES, FL 34639-4638
(304) 654-7557
Mailing address
22436 SOUTHSHORE DR, LAND O LAKES, FL 34639-4638
(304) 654-7557
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
08/14/2023
Last updated
08/14/2023
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