Organization · NPI-2

Brain Spa De LLC

Clinic/Center, Mental Health (Including Community Mental Health Center) · Wilmington, DE

NPI number1861081499
StatusActive
Last updated in NPPESJan 18, 2021

Details

NPI
1861081499
Entity type
Organization (NPI-2)
Legal business name
Brain Spa De LLC
Organization subpart
No
Enumeration date
Jan 18, 2021
Certification date
Jan 18, 2021
Last updated
Jan 18, 2021

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center)––Yes

Practice location

410 Foulk Rd Ste 105
Wilmington, DE 19803-3835

Phone 302-312-9478

Mailing address

1 Harbison Way
Columbia, SC 29212-3422

Phone 803-768-4348

Authorized official

Sandeep Gupta
Owner
3024786199

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