Organization
MINDSHIFTERS SOLUTION LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. YULANDAR SUE SIMMONS (OWNER)
(803) 824-9558
Entity
Organization
Contact information
Practice address
437 LAURENS AVE S, FAIRFAX, SC 29827-5302
(803) 824-9558
Mailing address
437 LAURENS AVE S, FAIRFAX, SC 29827-5302
(803) 824-9558
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
Other
Enumeration date
01/16/2024
Last updated
01/16/2024
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