Healthcare Provider Details

I. General information

NPI: 1659203560
Provider Name (Legal Business Name): REFINE MIND MENTAL HEALTH SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/03/2026
Last Update Date: 06/03/2026
Certification Date: 06/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

169 BEACH RD
POQUOSON VA
23662-1101
US

IV. Provider business mailing address

169 BEACH RD
POQUOSON VA
23662-1101
US

V. Phone/Fax

Practice location:
  • Phone: 757-871-2978
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name: TANESHA TYLER
Title or Position: OWNER
Credential:
Phone: 757-871-2978