MEDICARE: RENEW CONSULTING, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	320800000X	Mental Illness Community Based Residential Treatment Facility	200016	OR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1225373053
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RENEW CONSULTING, INC.

Provider Business Mailing Address
First Line	:	808 OLD SALEM RD NE
Second Line	:
City	:	ALBANY
State	:	OR
Zip	:	97321-4539
Country	:	US
Telephone Number	:	503-851-8219
Fax Number	:	541-981-2127

Provider Business Practice Location Address
First Line	:	34118 NE COLORADO LAKE DR
Second Line	:
City	:	CORVALLIS
State	:	OR
Zip	:	97333-2242
Country	:	US
Telephone Number	:	503-851-8219
Fax Number	:	541-981-2127

Authorized Official
Title or Position	:	PRESIDENT
Name	:	KATHY R ARONSON
Credential	:
Telephone Number	:	503-851-8219

Provider Enumeration Date	:	12/05/2012
Last Update Date	:	12/05/2012

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