MEDICARE: A RENEWED CHANCE LLC

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	261QR0405X	Substance Use Disorder Rehabilitation Clinic/Center

General Provider Information

NPI Number	:	1871440446
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	A RENEWED CHANCE LLC

Provider Business Mailing Address
First Line	:	4241 MAPLEVIEW DR
Second Line	:
City	:	BEAVERCREEK
State	:	OH
Zip	:	45432-1827
Country	:	US
Telephone Number	:
Fax Number	:	937-630-4482

Provider Business Practice Location Address
First Line	:	4241 MAPLEVIEW DR
Second Line	:
City	:	BEAVERCREEK
State	:	OH
Zip	:	45432-1827
Country	:	US
Telephone Number	:	937-993-9160
Fax Number	:	937-630-4482

Authorized Official
Title or Position	:	FOUNDER / OWNER
Name	:	AMANDA L PIERCE
Credential	:
Telephone Number	:	937-993-9160

Provider Enumeration Date	:	03/12/2026
Last Update Date	:	03/12/2026

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Directions to “A RENEWED CHANCE LLC ” Practice Location

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