Provider Demographics
NPI:1932837747
Name:MINDFUL LIFE COMPANY LTD LLP
Entity Type:Organization
Organization Name:MINDFUL LIFE COMPANY LTD LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MYKIA
Authorized Official - Middle Name:
Authorized Official - Last Name:HOLLIS-GRIFFITH
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:254-290-8577
Mailing Address - Street 1:400 W JASPER DR STE 202
Mailing Address - Street 2:
Mailing Address - City:KILLEEN
Mailing Address - State:TX
Mailing Address - Zip Code:76542-1322
Mailing Address - Country:US
Mailing Address - Phone:254-251-8750
Mailing Address - Fax:512-686-1935
Practice Address - Street 1:2913 WILLIAMS DR STE 220
Practice Address - Street 2:
Practice Address - City:GEORGETOWN
Practice Address - State:TX
Practice Address - Zip Code:78628-2739
Practice Address - Country:US
Practice Address - Phone:254-290-8577
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-10
Last Update Date:2022-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental HealthGroup - Multi-Specialty