MANDALA RESTORATIVE THERAPY NPI 1336624634

NPI Information

NPI: 1336624634
Provider Name: MANDALA RESTORATIVE THERAPY
Classification: Clinic/Center - 261QM0801X
Entity Type: Organization

Specialization: Mental Health (Including Community Mental Health Center)

Address:
5215 N RAVENSWOOD AVE STE 214
CHICAGO, IL
ZIP 60640
Phone: (602) 821-7850
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MANDALA RESTORATIVE THERAPY is a mental health (including community mental health center) clinic center in Chicago, IL. MANDALA RESTORATIVE THERAPY NPI is 1336624634. The provider is registered as an organization entity type.

The provider's business location address is:

5215 N RAVENSWOOD AVE STE 214
CHICAGO, IL
ZIP 60640-670
Phone: (602) 821-7850

The provider's authorized official is Tessa Marie Mandala .
The authorized official title is Owner/licensed Clinician and has the following contact phone number (602) 821-7850.

The enumeration date for this NPI number is 10/2/2018 and was last updated on 10/2/2018.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QM0801X	Clinic/Center	Mental Health (Including Community Mental Health Center)			Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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