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General NPI Number Information
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NPI Number | 1790049989
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Entity Type | Organization
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Legal Business Name | THERAMIND SERVICES, INC.
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Dates
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Enumeration Date | 07/02/2012
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Last Update Date | 07/02/2012
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Provider Practice Location Address
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Address Line | 977 LAKEVIEW PKWY SUITE 190
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City | VERNON HILLS
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State | IL
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Zip | 60061-1400
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Country | US
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Telephone | 312-543-0188
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Fax |
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Provider Business Mailing Address
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Address Line | 5651 W CAMINO CIELO
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City | SANTA BARBARA
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State | CA
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Zip | 93105-9706
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Country | US
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Telephone | 312-543-0188
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Fax | 877-264-0642
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Authorized Official
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Title or Position | PRESIDENT & CHIEF OPERATING OFFICER
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Name | MR. MARK M. HEATWOLE
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Credential |
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Telephone | 312-543-0188
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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