Provider Demographics
NPI:1245603331
Name:RENEWED MINDS BEHAVIORAL CENTER
Entity Type:Organization
Organization Name:RENEWED MINDS BEHAVIORAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:KARLIN
Authorized Official - Middle Name:
Authorized Official - Last Name:RICHARDSON
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:318-512-4997
Mailing Address - Street 1:PO BOX 2911
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:LA
Mailing Address - Zip Code:71207-2911
Mailing Address - Country:US
Mailing Address - Phone:318-372-1980
Mailing Address - Fax:318-600-6095
Practice Address - Street 1:1201 N 5TH ST
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:LA
Practice Address - Zip Code:71201-5317
Practice Address - Country:US
Practice Address - Phone:318-512-4997
Practice Address - Fax:318-600-6095
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-11
Last Update Date:2023-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)