Provider Demographics
NPI:1932757937
Name:HEALTHY MIND FIT BODY
Entity Type:Organization
Organization Name:HEALTHY MIND FIT BODY
Other - Org Name:THE FOCUSED MINDFULNESS CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GARRETT
Authorized Official - Middle Name:
Authorized Official - Last Name:BROOKMYER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:269-371-3700
Mailing Address - Street 1:8080 MOORSBRIDGE RD STE 203
Mailing Address - Street 2:
Mailing Address - City:PORTAGE
Mailing Address - State:MI
Mailing Address - Zip Code:49024-4422
Mailing Address - Country:US
Mailing Address - Phone:269-371-3700
Mailing Address - Fax:
Practice Address - Street 1:8080 MOORSBRIDGE RD STE 203
Practice Address - Street 2:
Practice Address - City:PORTAGE
Practice Address - State:MI
Practice Address - Zip Code:49024-4422
Practice Address - Country:US
Practice Address - Phone:269-371-3700
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-03
Last Update Date:2023-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)