Organization
MINDFUL BEHAVIORAL HEALTHCARE, LLC
Active
Organization
MINDFUL BEHAVIORAL HEALTHCARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHELLE MISSIGMAN (AO)
(352) 328-9139
Entity
Organization
Contact information
Practice address
10920 MOSS PARK RD STE 200, ORLANDO, FL 32832-6087
(407) 846-0533
(407) 518-1730
Mailing address
717 E OAK ST, KISSIMMEE, FL 34744-4580
(407) 846-0533
(407) 518-1730
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
019725402
—
FL
Enumeration date
09/17/2021
Last updated
01/26/2022
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