MEDICARE: MIND BODY SUCCESS INITIATIVE

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	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1699620906
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MIND BODY SUCCESS INITIATIVE

Provider Business Mailing Address
First Line	:	3232 RULO RD APT 3
Second Line	:
City	:	TOLEDO
State	:	OH
Zip	:	43613-1827
Country	:	US
Telephone Number	:	567-395-5348
Fax Number	:

Provider Business Practice Location Address
First Line	:	3232 RULO RD APT 3
Second Line	:
City	:	TOLEDO
State	:	OH
Zip	:	43613-1827
Country	:	US
Telephone Number	:	567-395-5348
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	DIANA URBANSKI
Credential	:
Telephone Number	:	567-395-5348

Provider Enumeration Date	:	03/02/2026
Last Update Date	:	03/02/2026

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Directions to “MIND BODY SUCCESS INITIATIVE ” Practice Location

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