Provider Demographics
NPI:1770284655
Name:HOLISTIC MINDSET, LLC
Entity type:Organization
Organization Name:HOLISTIC MINDSET, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AGENTE RESIDENTE
Authorized Official - Prefix:
Authorized Official - First Name:YESENIA
Authorized Official - Middle Name:
Authorized Official - Last Name:PACHECO LLANOS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-628-4616
Mailing Address - Street 1:HH30 CALLE SANDY
Mailing Address - Street 2:URB. BAYAMON GARDENS
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00957
Mailing Address - Country:US
Mailing Address - Phone:787-628-4616
Mailing Address - Fax:
Practice Address - Street 1:AVE RAMON LUIS RIVERA
Practice Address - Street 2:EDIFICIO GALLARDO OFIC 204
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00961
Practice Address - Country:US
Practice Address - Phone:939-599-2197
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-16
Last Update Date:2023-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
No103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
No104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty
No2084B0040XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyBehavioral Neurology & NeuropsychiatryGroup - Multi-Specialty