Provider Demographics
NPI:1598645228
Name:BODY & MIND WELLNESS CENTER
Entity type:Organization
Organization Name:BODY & MIND WELLNESS CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:DUMITRU
Authorized Official - Middle Name:
Authorized Official - Last Name:ASANACHE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:570-540-6653
Mailing Address - Street 1:95 N PRINCETON CIR
Mailing Address - Street 2:
Mailing Address - City:LYNCHBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24503-1554
Mailing Address - Country:US
Mailing Address - Phone:570-540-6653
Mailing Address - Fax:
Practice Address - Street 1:3700 OLD FOREST RD
Practice Address - Street 2:
Practice Address - City:LYNCHBURG
Practice Address - State:VA
Practice Address - Zip Code:24501-6961
Practice Address - Country:US
Practice Address - Phone:570-540-6653
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-04
Last Update Date:2025-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty