Provider Demographics
NPI:1336869502
Name:MINDFUL MOMENTS, LLC
Entity Type:Organization
Organization Name:MINDFUL MOMENTS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:MARGARET
Authorized Official - Middle Name:
Authorized Official - Last Name:ISOH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:202-316-0228
Mailing Address - Street 1:8160 WASHINGTON BLVD
Mailing Address - Street 2:
Mailing Address - City:JESSUP
Mailing Address - State:MD
Mailing Address - Zip Code:20794-8812
Mailing Address - Country:US
Mailing Address - Phone:202-316-0228
Mailing Address - Fax:
Practice Address - Street 1:8160 WASHINGTON BLVD
Practice Address - Street 2:
Practice Address - City:JESSUP
Practice Address - State:MD
Practice Address - Zip Code:20794-8812
Practice Address - Country:US
Practice Address - Phone:202-316-0228
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-29
Last Update Date:2022-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)