Provider Demographics
NPI:1053095604
Name:HEALTHY MINDS OF MICHIGAN
Entity type:Organization
Organization Name:HEALTHY MINDS OF MICHIGAN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOCIAL WORKER
Authorized Official - Prefix:
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:
Authorized Official - Last Name:CILLEY
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW
Authorized Official - Phone:989-455-8214
Mailing Address - Street 1:5103 EASTMAN AVE STE 117
Mailing Address - Street 2:
Mailing Address - City:MIDLAND
Mailing Address - State:MI
Mailing Address - Zip Code:48640-6723
Mailing Address - Country:US
Mailing Address - Phone:989-455-8214
Mailing Address - Fax:
Practice Address - Street 1:5103 EASTMAN AVE STE 117
Practice Address - Street 2:
Practice Address - City:MIDLAND
Practice Address - State:MI
Practice Address - Zip Code:48640-6723
Practice Address - Country:US
Practice Address - Phone:989-455-8214
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-14
Last Update Date:2023-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty