Provider Demographics
NPI:1225728645
Name:MINDHEALTH WELLNESS INC.
Entity Type:Organization
Organization Name:MINDHEALTH WELLNESS INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RODOLFO
Authorized Official - Middle Name:A
Authorized Official - Last Name:AREVALO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:562-896-1106
Mailing Address - Street 1:1217 W WHITTIER BLVD
Mailing Address - Street 2:
Mailing Address - City:MONTEBELLO
Mailing Address - State:CA
Mailing Address - Zip Code:90640-4642
Mailing Address - Country:US
Mailing Address - Phone:323-524-9347
Mailing Address - Fax:
Practice Address - Street 1:1217 W WHITTIER BLVD
Practice Address - Street 2:
Practice Address - City:MONTEBELLO
Practice Address - State:CA
Practice Address - Zip Code:90640-4642
Practice Address - Country:US
Practice Address - Phone:323-524-9347
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-09
Last Update Date:2023-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health