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NPI Code Detail

MEDICARE: MIND & BODY/ MENTAL REHAB, LLC

MEDICARE: MIND & BODY/ MENTAL REHAB, LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1251S00000XCommunity/Behavioral Health Agency
2261QM0801XMental Health Clinic/Center (Including Community Mental Health Center)
3363LP0808XPsychiatric/Mental Health Nurse Practitioner

General Provider Information

NPI Number : 1710759162
Entity Type Code : Organization
Provider Name (Legal Business Name) : MIND & BODY/ MENTAL REHAB, LLC
Provider Business Mailing Address
First Line : 1406 WESTWOOD AVE STE 207
Second Line :
City : LAKEWOOD
State : OH
Zip : 44107-3716
Country : US
Telephone Number : 216-925-4228
Fax Number : 216-208-1412
Provider Business Practice Location Address
First Line : 1406 WESTWOOD AVE STE 207
Second Line :
City : LAKEWOOD
State : OH
Zip : 44107-3716
Country : US
Telephone Number : 216-925-4228
Fax Number : 216-208-1412
Authorized Official
Title or Position : OWNER OF ENTITY/CEO
Name : MARGARITA PEREZ
Credential : APRN, PMHNP-BC
Telephone Number : 440-298-2740
Provider Enumeration Date : 10/27/2023
Last Update Date : 11/24/2025

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