Provider Demographics
NPI:1477291631
Name:BEAUTIFUL MIND BEHAVIOR HEALTH AND WELLNESS LLC
Entity Type:Organization
Organization Name:BEAUTIFUL MIND BEHAVIOR HEALTH AND WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HAWAH
Authorized Official - Middle Name:COMFORT
Authorized Official - Last Name:GUAR
Authorized Official - Suffix:
Authorized Official - Credentials:APRN, PMHNP
Authorized Official - Phone:240-423-5186
Mailing Address - Street 1:1176 UPPER SHOAL WAY
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30045-7017
Mailing Address - Country:US
Mailing Address - Phone:240-423-5186
Mailing Address - Fax:
Practice Address - Street 1:1176 UPPER SHOAL WAY
Practice Address - Street 2:
Practice Address - City:LAWRENCEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30045-7017
Practice Address - Country:US
Practice Address - Phone:240-423-5186
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-26
Last Update Date:2022-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty