34D2282414 CLIA NUMBER - HEALTHY MINDS LLC

Laboratory Demographics

CLIA Number: 34D2282414

Facility Name: HEALTHY MINDS LLC

Facility Address:
4401 E INDEPENDENCE BLVD STE 208 G
CHARLOTTE, NC
ZIP 28205
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Facility Phone Number: 704 833-8355

Facility Type: Other - MENTAL HEALTH AGENCY

Certificate Type: Waiver

NPI Number: 1609650258

Taxonomy: 101YP2500X - Counselor

CLIA Record

Field Name	Field Value
CLIA Number	34D2282414
LAB Type	Other - MENTAL HEALTH AGENCY
Facility Name	HEALTHY MINDS LLC
Street	4401 E INDEPENDENCE BLVD STE 208 G
City	CHARLOTTE
State	NC
ZIP	28205
Phone	704 833-8355
CertificateType	4
CertificateEffectiveDate	5/22/2023
CertificateExpirationDate	5/21/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024