Provider Demographics
NPI:1093432403
Name:FREE MIND INTEGRATED SERVICES LLC
Entity Type:Organization
Organization Name:FREE MIND INTEGRATED SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:STACEY
Authorized Official - Middle Name:MICHELLE
Authorized Official - Last Name:ROWE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:202-677-9732
Mailing Address - Street 1:9718 POLING TER
Mailing Address - Street 2:
Mailing Address - City:FORT WASHINGTON
Mailing Address - State:MD
Mailing Address - Zip Code:20744-3970
Mailing Address - Country:US
Mailing Address - Phone:202-677-9732
Mailing Address - Fax:470-705-9700
Practice Address - Street 1:9718 POLING TER
Practice Address - Street 2:
Practice Address - City:FORT WASHINGTON
Practice Address - State:MD
Practice Address - Zip Code:20744-3970
Practice Address - Country:US
Practice Address - Phone:202-677-9732
Practice Address - Fax:470-705-9700
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-26
Last Update Date:2023-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty