Provider Demographics
NPI:1225884935
Name:RHEMA DIAGNOSTIC AND MINDFULNESS
Entity type:Organization
Organization Name:RHEMA DIAGNOSTIC AND MINDFULNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:D
Authorized Official - Last Name:MOORE
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC
Authorized Official - Phone:301-785-8865
Mailing Address - Street 1:1701 WALKUS CT
Mailing Address - Street 2:
Mailing Address - City:DISTRICT HEIGHTS
Mailing Address - State:MD
Mailing Address - Zip Code:20747-1892
Mailing Address - Country:US
Mailing Address - Phone:301-785-8865
Mailing Address - Fax:
Practice Address - Street 1:7822 PARSTON DR
Practice Address - Street 2:
Practice Address - City:DISTRICT HEIGHTS
Practice Address - State:MD
Practice Address - Zip Code:20747-4424
Practice Address - Country:US
Practice Address - Phone:301-785-8865
Practice Address - Fax:301-420-1476
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-24
Last Update Date:2024-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center