MEDICARE: RENEWED MINDS TREATMENT CENTER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number	:	1043142110
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RENEWED MINDS TREATMENT CENTER

Provider Business Mailing Address
First Line	:	13205 BEACHWOOD AVE
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44105-6413
Country	:	US
Telephone Number	:	216-408-5218
Fax Number	:

Provider Business Practice Location Address
First Line	:	13205 BEACHWOOD AVE
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44105-6413
Country	:	US
Telephone Number	:	216-408-5218
Fax Number	:

Authorized Official
Title or Position	:	MANAGING PARTNER
Name	:	TIFFANEY HOLLAND
Credential	:	LPN
Telephone Number	:	216-408-5218

Provider Enumeration Date	:	06/02/2026
Last Update Date	:	06/02/2026

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