Provider Demographics
NPI:1053919225
Name:MIND AND BODY WELLNESS CENTER INC.
Entity type:Organization
Organization Name:MIND AND BODY WELLNESS CENTER INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:MOSHE
Authorized Official - Middle Name:
Authorized Official - Last Name:BACHAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:404-800-5181
Mailing Address - Street 1:1801 PEACHTREE ST NE STE 300
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30309-1859
Mailing Address - Country:US
Mailing Address - Phone:404-800-5181
Mailing Address - Fax:404-800-5797
Practice Address - Street 1:10475 MEDLOCK BRIDGE RD STE 820
Practice Address - Street 2:
Practice Address - City:JOHNS CREEK
Practice Address - State:GA
Practice Address - Zip Code:30097-4437
Practice Address - Country:US
Practice Address - Phone:404-800-5181
Practice Address - Fax:404-800-5797
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-11
Last Update Date:2024-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207RA0401XAllopathic & Osteopathic PhysiciansInternal MedicineAddiction MedicineGroup - Multi-Specialty