Provider Demographics
NPI:1487180733
Name:RESTORING MENTAL WELLNESS, LLC
Entity Type:Organization
Organization Name:RESTORING MENTAL WELLNESS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHIATRIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TARA
Authorized Official - Middle Name:
Authorized Official - Last Name:MAYES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:614-595-1393
Mailing Address - Street 1:1985 HENDERSON RD
Mailing Address - Street 2:#136
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43220-2401
Mailing Address - Country:US
Mailing Address - Phone:614-595-1393
Mailing Address - Fax:614-890-5485
Practice Address - Street 1:1985 HENDERSON RD
Practice Address - Street 2:#136
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43220-2401
Practice Address - Country:US
Practice Address - Phone:614-595-1393
Practice Address - Fax:614-890-5485
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-05
Last Update Date:2017-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH914822084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty