Provider Demographics
NPI:1801333232
Name:RENEWING MINDS MENTAL HEALTH GROUP
Entity type:Organization
Organization Name:RENEWING MINDS MENTAL HEALTH GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:SHAUN
Authorized Official - Middle Name:
Authorized Official - Last Name:RILEY
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:202-867-9394
Mailing Address - Street 1:55 HARRY S TRUMAN DR
Mailing Address - Street 2:SUITE 31
Mailing Address - City:LARGO
Mailing Address - State:MD
Mailing Address - Zip Code:20774-1047
Mailing Address - Country:US
Mailing Address - Phone:202-867-9394
Mailing Address - Fax:
Practice Address - Street 1:55 HARRY S TRUMAN DR
Practice Address - Street 2:SUITE 31
Practice Address - City:LARGO
Practice Address - State:MD
Practice Address - Zip Code:20774-1047
Practice Address - Country:US
Practice Address - Phone:202-867-9394
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-24
Last Update Date:2017-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty