Provider Demographics
NPI:1053829598
Name:MIND RENEWALS INC
Entity type:Organization
Organization Name:MIND RENEWALS INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:
Authorized Official - Last Name:ATKINS
Authorized Official - Suffix:
Authorized Official - Credentials:EDD, LCSW
Authorized Official - Phone:901-468-3349
Mailing Address - Street 1:1005 TILLMAN ST STE 217
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38112-2038
Mailing Address - Country:US
Mailing Address - Phone:901-468-3349
Mailing Address - Fax:
Practice Address - Street 1:1005 TILLMAN ST STE 217
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38112-2038
Practice Address - Country:US
Practice Address - Phone:901-468-3349
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-18
Last Update Date:2018-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)