Organization
MIND BODY OPTIMIZATION ONLINE, LLC
Active
Organization
MIND BODY OPTIMIZATION ONLINE, LLC
Active
Other names
Mind Body Optimization
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DAVID J MORAINE ESQ (LEGAL COUNSEL)
(469) 990-3626
Entity
Organization
Contact information
Practice address
5405 W 151ST ST, LEAWOOD, KS 66224-8700
(682) 900-6631
(800) 416-8145
Mailing address
16 VILLAGE LN STE 200, COLLEYVILLE, TX 76034-2948
(682) 900-6631
(800) 416-8145
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
Other
Enumeration date
03/10/2025
Last updated
01/21/2026
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