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
8040 GEORGIA AVE STE 170, SILVER SPRING, MD 20910-4959
(888) 879-9786
Mailing address
8040 GEORGIA AVE STE 170, SILVER SPRING, MD 20910-4959
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
—
—
251B00000X
Case Management Agency
—
MD
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1558843813
—
NC
05
—
250004132
—
NV
05
—
951032000
—
MD
Enumeration date
09/04/2018
Last updated
01/11/2024
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