FOREVERMORE MIND BODY & SOUL
NPI 1346025285
Clinic/Center in Joliet, IL
- Organization
- Clinic/Center
About FOREVERMORE MIND BODY & SOUL
This page provides the complete NPI Profile along with additional information for Forevermore Mind Body & Soul, a provider established in Joliet, Illinois operating as a Clinic/center. The healthcare provider is registered in the NPI registry with number 1346025285 assigned on August 2023. The practitioner's primary taxonomy code is 261Q00000X. The provider is registered as an organization and their NPI record was last updated one year ago. The authorized official of this NPI record is Mr. Demitrius Brackett Pain (Mental Health Provider)
- NPI
- 1346025285 Verify this NPI
- Provider Name
- FOREVERMORE MIND BODY & SOUL
- Other Name Type
- (6)
- Entity Type
- Organization
- Location Address
- 411 N BLUFF ST APT 11 JOLIET, IL 60435
- Location Phone
- (815) 766-5999
- Mailing Address
- 411 N BLUFF ST APT 11 JOLIET, IL 60435
- Mailing Phone
- (815) 766-5999
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 08-29-2023
- Last Update Date
- 12-03-2025
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Clinic/Center
- Taxonomy Code
- 261Q00000X
- Type
- Ambulatory Health Care Facilities
- Taxonomy Description
- A facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 174200000X | Other Service Providers | Meals | |
| 2 | 261QC1500X | Ambulatory Health Care Facilities | Clinic/Center | |
| 3 | 261QM1300X | Ambulatory Health Care Facilities | Clinic/Center | |
| 4 | 261QP3300X | Ambulatory Health Care Facilities | Clinic/Center | |
| 5 | 261QR1100X | Ambulatory Health Care Facilities | Clinic/Center |
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Other Providers at the Same Location
The following 1 provider is registered at the same or a nearby location.
JOLIET, IL 60435
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1346025285, enumerated as an "organization" on August 29, 2023.
The provider is located at 411 N BLUFF ST APT 11 JOLIET, IL 60435 and the phone number is (815) 766-5999.
Clinic/Center with taxonomy code 261Q00000X.
