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General NPI Number Information
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NPI Number | 1558294793
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Entity Type | Organization
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Legal Business Name | GRANDEUR MINDS
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Dates
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Enumeration Date | 06/06/2026
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Last Update Date | 06/06/2026
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Provider Practice Location Address
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Address Line | 1544 S BYRNE RD STE J
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City | TOLEDO
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State | OH
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Zip | 43614-3431
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Country | US
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Telephone | 419-413-0405
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Fax |
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Provider Business Mailing Address
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Address Line | 1544 S BYRNE RD STE J
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City | TOLEDO
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State | OH
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Zip | 43614-3431
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Country | US
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Telephone | 419-413-0405
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MICHELLE JEFFRIES
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Credential |
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Telephone | 419-413-0405
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WC0400X
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Taxonomy Name | Case Management Registered Nurse
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 163WC1500X
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Taxonomy Name | Community Health Registered Nurse
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 320800000X
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Taxonomy Name | Mental Illness Community Based Residential Treatment Facility
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License Number |
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License Number State |
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