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General NPI Number Information
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NPI Number | 1760331003
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Entity Type | Organization
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Legal Business Name | WHOLE MIND WELLNESS INITIATIVE
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Dates
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Enumeration Date | 01/28/2026
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Last Update Date | 01/28/2026
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Provider Practice Location Address
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Address Line | 1940 STAUNTON RD
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City | CLEVELAND HEIGHTS
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State | OH
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Zip | 44118-2252
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Country | US
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Telephone | 216-326-2472
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Fax |
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Provider Business Mailing Address
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Address Line | 1940 STAUNTON RD
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City | CLEVELAND HEIGHTS
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State | OH
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Zip | 44118-2252
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Country | US
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Telephone | 216-326-2472
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Fax |
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Authorized Official
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Title or Position | OWNER/OPERATOR
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Name | PENNY WILLIS
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Credential | LSW
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Telephone | 216-326-2472
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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 |
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License Number State |
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