Organization
BRAIN SPA DE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SANDEEP GUPTA (OWNER)
(302) 478-6199
Entity
Organization
Contact information
Practice address
410 FOULK RD STE 105, WILMINGTON, DE 19803-3835
(302) 312-9478
Mailing address
1 HARBISON WAY, COLUMBIA, SC 29212-3422
(803) 768-4348
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
01/18/2021
Last updated
01/18/2021
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