Provider Demographics
NPI:1548617905
Name:HEALTHY BODY HEALTHY MIND LLC
Entity Type:Organization
Organization Name:HEALTHY BODY HEALTHY MIND LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO-FOUNDER
Authorized Official - Prefix:MR
Authorized Official - First Name:ALEX
Authorized Official - Middle Name:
Authorized Official - Last Name:TORRES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-325-5004
Mailing Address - Street 1:97 GRAND AVENUE
Mailing Address - Street 2:
Mailing Address - City:ISELIN
Mailing Address - State:NJ
Mailing Address - Zip Code:08830
Mailing Address - Country:US
Mailing Address - Phone:732-325-5004
Mailing Address - Fax:
Practice Address - Street 1:97 GRAND AVENUE
Practice Address - Street 2:
Practice Address - City:ISELIN
Practice Address - State:NJ
Practice Address - Zip Code:08830
Practice Address - Country:US
Practice Address - Phone:732-325-5004
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-16
Last Update Date:2016-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health