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Organization

A RENEWED MIND

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. JAMES JEFFREY EARLE MAE, MRC; CDCA; LPC (CLINICAL THERAPIST)
(419) 873-8280
Entity
Organization

Contact information

Practice address
900 W SOUTH BOUNDARY ST BLDG 2, PERRYSBURG, OH 43551-5230
(419) 873-8280
(419) 873-8320
Mailing address
1704 CASS RD, MAUMEE, OH 43537-2331
(614) 962-0264

Taxonomy

Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
C.0500399
OH

Other

Enumeration date
09/21/2011
Last updated
09/21/2011
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