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General NPI Number Information
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NPI Number | 1629743042
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Entity Type | Organization
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Legal Business Name | RESTORATIVE MINDS BEHAVIORAL HEALTH SERVICES, PLLC
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Dates
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Enumeration Date | 08/09/2021
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Last Update Date | 01/17/2025
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Provider Practice Location Address
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Address Line | 401 W COMMERCIAL AVE
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City | MONTEREY
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State | TN
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Zip | 38574-1113
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Country | US
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Telephone | 931-644-9049
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 822
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City | MONTEREY
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State | TN
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Zip | 38574-0822
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | AMBER MATHENEY
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Credential | PMHNP-BC
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Telephone | 931-229-0350
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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