Provider Demographics
NPI:1477795383
Name:CLEAR MINDS
Entity Type:Organization
Organization Name:CLEAR MINDS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:
Authorized Official - Last Name:GERARDI
Authorized Official - Suffix:
Authorized Official - Credentials:APN
Authorized Official - Phone:302-644-2773
Mailing Address - Street 1:PO BOX 30
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:DE
Mailing Address - Zip Code:19960-0030
Mailing Address - Country:US
Mailing Address - Phone:302-644-2773
Mailing Address - Fax:
Practice Address - Street 1:34444 KING STREET ROW
Practice Address - Street 2:SUITE 4B
Practice Address - City:LEWES
Practice Address - State:DE
Practice Address - Zip Code:19958-1514
Practice Address - Country:US
Practice Address - Phone:302-644-2773
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-25
Last Update Date:2011-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DELI-0000107261QM0850X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health