Organization
RENEWED MIND - MENTAL HEALTH LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TOUSSAINT GOLDING (OWNER OF ENTITY)
(772) 812-0168
Entity
Organization
Contact information
Practice address
130 S INDIAN RIVER DR STE 202, FORT PIERCE, FL 34950-4353
(772) 812-0168
Mailing address
130 S INDIAN RIVER DR STE 202, FORT PIERCE, FL 34950-4353
(772) 812-0168
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
07/13/2023
Last updated
07/13/2023
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