| Renew Your Mind Wellness Services Llc | |
|
9091 Snowden River Pkwy # 1316 Columbia MD 21046-1657 | |
| (443) 690-2272 | |
| (855) 450-1084 |
| Full Name | Renew Your Mind Wellness Services Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 9091 Snowden River Pkwy # 1316, Columbia, Maryland |
| Authorized Official Name and Position | Katia Coley (ADMIN/PROVIDER) |
| Authorized Official Contact | 2403503015 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Renew Your Mind Wellness Services Llc 9091 Snowden River Pkwy # 1316 Columbia MD 21046-1657 Ph: (443) 690-2272 | Renew Your Mind Wellness Services Llc 9091 Snowden River Pkwy # 1316 Columbia MD 21046-1657 Ph: (443) 690-2272 |
| NPI Number | 1396441416 |
|---|---|
| Provider Enumeration Date | 01/31/2023 |
| Last Update Date | 01/30/2024 |
| Certification Date | 01/30/2024 |
| Medicare PECOS PAC ID | 6901270602 |
|---|---|
| Medicare Enrollment ID | O20230321000279 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396441416 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Katia Coley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770982241 PECOS PAC ID: 8022335611 Enrollment ID: I20150319000302 |
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