Organization
EMBODIED HEART MIND LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LISSA EDMOND (OWNER/APN)
(973) 358-5558
Entity
Organization
Contact information
Practice address
20 SCOTCH RD, EWING, NJ 08628-2529
(973) 358-5558
Mailing address
PO BOX 2264, BLOOMFIELD, NJ 07003-9064
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
12/22/2019
Last updated
08/03/2021
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