Provider Demographics
NPI:1790049989
Name:THERAMIND SERVICES, INC.
Entity Type:Organization
Organization Name:THERAMIND SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT & CHIEF OPERATING OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:M
Authorized Official - Last Name:HEATWOLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:312-543-0188
Mailing Address - Street 1:5651 W CAMINO CIELO
Mailing Address - Street 2:
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93105-9706
Mailing Address - Country:US
Mailing Address - Phone:312-543-0188
Mailing Address - Fax:877-264-0642
Practice Address - Street 1:977 LAKEVIEW PKWY
Practice Address - Street 2:SUITE 190
Practice Address - City:VERNON HILLS
Practice Address - State:IL
Practice Address - Zip Code:60061-1400
Practice Address - Country:US
Practice Address - Phone:312-543-0188
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-02
Last Update Date:2012-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)