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NPI Code Detail

MEDICARE: A RENEWED MIND

MEDICARE: A RENEWED MIND
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 AgencyOH
2251S00000XCommunity/Behavioral Health Agency

General Provider Information

NPI Number : 1760749444
Entity Type Code : Organization
Provider Name (Legal Business Name) : A RENEWED MIND
Provider Business Mailing Address
First Line : 885 COMMERCE DR
Second Line :
City : PERRYSBURG
State : OH
Zip : 43551-5268
Country : US
Telephone Number : 419-330-1060
Fax Number : 419-931-6764
Provider Business Practice Location Address
First Line : 1832 ADAMS ST
Second Line :
City : TOLEDO
State : OH
Zip : 43604
Country : US
Telephone Number : 419-720-9247
Fax Number : 419-422-7801
Authorized Official
Title or Position : CREDENTIALING SPECIALIST
Name : CRYSTAL A HAMANN
Credential :
Telephone Number : 419-330-5115
Provider Enumeration Date : 04/18/2012
Last Update Date : 02/15/2017

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Directions to “A RENEWED MIND ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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