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General NPI Number Information
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NPI Number | 1730521592
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Entity Type | Organization
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Legal Business Name | A RENEWED MIND BEHAVIORAL HEALTH SERVICES
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Dates
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Enumeration Date | 07/22/2013
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Last Update Date | 07/22/2013
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Provider Practice Location Address
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Address Line | 7 CONIFER CT
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City | COLUMBIA
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State | SC
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Zip | 29229-9569
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Country | US
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Telephone | 803-414-6700
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Fax |
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Provider Business Mailing Address
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Address Line | 7 CONIFER CT
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City | COLUMBIA
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State | SC
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Zip | 29229-9569
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Country | US
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Telephone | 803-414-6700
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Fax |
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Authorized Official
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Title or Position | COUNSELOR
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Name | JOSETTA SUMTER COBB
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Credential | MA, LPC, CACII
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Telephone | 803-414-6700
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 5544
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License Number State | SC
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