Provider Demographics
NPI:1831998806
Name:MIND BODY AND SOUL EDIFICATION
Entity type:Organization
Organization Name:MIND BODY AND SOUL EDIFICATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ARENA
Authorized Official - Middle Name:THERESA
Authorized Official - Last Name:JAMES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:803-206-3779
Mailing Address - Street 1:126 OLDE SPRINGS RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29223-6030
Mailing Address - Country:US
Mailing Address - Phone:803-206-3779
Mailing Address - Fax:
Practice Address - Street 1:316 S 1ST ST
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:SC
Practice Address - Zip Code:29506-3501
Practice Address - Country:US
Practice Address - Phone:803-354-8800
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-11
Last Update Date:2025-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health