Provider Demographics
NPI:1669254223
Name:MINDSET WELLNESS LLP
Entity type:Organization
Organization Name:MINDSET WELLNESS LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:NELMAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:208-704-2062
Mailing Address - Street 1:1022 N 4TH ST STE 101
Mailing Address - Street 2:
Mailing Address - City:COEUR D ALENE
Mailing Address - State:ID
Mailing Address - Zip Code:83814-3100
Mailing Address - Country:US
Mailing Address - Phone:208-704-2062
Mailing Address - Fax:
Practice Address - Street 1:1022 N 4TH ST STE 101
Practice Address - Street 2:
Practice Address - City:COEUR D ALENE
Practice Address - State:ID
Practice Address - Zip Code:83814-3100
Practice Address - Country:US
Practice Address - Phone:208-704-2062
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-18
Last Update Date:2023-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty