Renest Recovery Support Service Rockford Llc | |
910 2nd Ave Rockford IL 61104-2162 | |
(270) 839-6743 | |
Not Available |
Full Name | Renest Recovery Support Service Rockford Llc |
---|---|
Speciality | Clinic/center - Adult Mental Health |
Location | 910 2nd Ave, Rockford, Illinois |
Authorized Official Name and Position | Christina Nicole Hobson (AUTHORIZED OFFICIAL, HUMAN RESOURCE) |
Authorized Official Contact | 2708396743 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Renest Recovery Support Service Rockford Llc 910 2nd Ave Rockford IL 61104-2162 Ph: (270) 839-6743 | Renest Recovery Support Service Rockford Llc 910 2nd Ave Rockford IL 61104-2162 Ph: (270) 839-6743 |
NPI Number | 1093307266 |
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Provider Enumeration Date | 02/09/2021 |
Last Update Date | 11/03/2022 |
Certification Date | 11/03/2022 |
Identifier | Type | State | Issuer |
---|---|---|---|
1093307266 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
261QM0855X | Clinic/center - Adolescent And Children Mental Health | (* (Not Available)) | Secondary |
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