Provider Demographics
NPI:1891492443
Name:MINDING MIND BIZNEZZ, LLC
Entity Type:Organization
Organization Name:MINDING MIND BIZNEZZ, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:DISHEKA
Authorized Official - Middle Name:DENISE
Authorized Official - Last Name:BEVERLY-DANIELS
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW-C
Authorized Official - Phone:313-574-5542
Mailing Address - Street 1:43157 WASHINGTON WAY
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:MI
Mailing Address - Zip Code:48187-3057
Mailing Address - Country:US
Mailing Address - Phone:313-574-5542
Mailing Address - Fax:
Practice Address - Street 1:42807 FORD RD STE 121
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:MI
Practice Address - Zip Code:48187-3357
Practice Address - Country:US
Practice Address - Phone:313-574-5542
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-14
Last Update Date:2023-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)Group - Single Specialty