Provider Demographics
NPI:1023558780
Name:A BEAUTIFUL MIND LLC
Entity Type:Organization
Organization Name:A BEAUTIFUL MIND LLC
Other - Org Name:UNITYPRO HOME CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:DELASANDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:KELLY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:269-338-9500
Mailing Address - Street 1:331 HIGH ST
Mailing Address - Street 2:
Mailing Address - City:BENTON HARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:49022-4523
Mailing Address - Country:US
Mailing Address - Phone:269-338-9500
Mailing Address - Fax:
Practice Address - Street 1:331 HIGH ST
Practice Address - Street 2:
Practice Address - City:BENTON HARBOR
Practice Address - State:MI
Practice Address - Zip Code:49022-4523
Practice Address - Country:US
Practice Address - Phone:269-338-9500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-28
Last Update Date:2017-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health