Provider Demographics
NPI:1093445330
Name:HEALWELLMIND LLC
Entity Type:Organization
Organization Name:HEALWELLMIND LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:REJI
Authorized Official - Middle Name:
Authorized Official - Last Name:ABHILASH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-883-1938
Mailing Address - Street 1:266 NEW MARK ESPLANADE
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20850-2733
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6209 EXECUTIVE BLVD
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20852-3906
Practice Address - Country:US
Practice Address - Phone:301-883-1938
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-10
Last Update Date:2022-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)