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RENEW RECOVERY, LLC

Ambulatory Health Care Facilities Clinic/Center Medical Specialty

Provider NPI: 1316441975

Organization Information:
Organization Name:  RENEW RECOVERY, LLC
Organization is not Subpart
Authorized Official:  WILLIAM  DAWSON  COO  502-749-6249

Practice Location:
599 FREEDOM PARK DR  CRESTVIEW HILLS, KY 41017 US
Tel: 502-749-6249  Fax: --

Business Mailing Address:
599 FREEDOM PARK DR  CRESTVIEW HILLS, KY 41017-5130 US
Tel: --  Fax: --

NPI Information:
NPI: 1316441975
Entity Type: Organization

Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
N261QM2500XAmbulatory Health Care Facilities
Clinic/Center
Medical Specialty
N324500000XResidential Treatment Facilities
Substance Abuse Rehabilitation Facility
Y261QR0405XAmbulatory Health Care Facilities
Clinic/Center

Other Provider Identifiers:

IssuerNumberStateType



American Medical Association 2012 taxonomy code information

Code: 261QR0405X

Type:

Classification:



Definition:



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