Organization
MIND DYNAMICS LLC
Active
Organization
MIND DYNAMICS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PETER LOTTERHOS (OWNER)
(310) 415-1148
Entity
Organization
Contact information
Practice address
17 FARMINGTON AVE STE B4, PLAINVILLE, CT 06062-1774
(310) 415-1148
Mailing address
17 FARMINGTON AVE STE B4, PLAINVILLE, CT 06062-1774
(310) 415-1148
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
—
—
Other
Enumeration date
08/29/2022
Last updated
12/19/2023
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