Healthcare Provider Details

I. General information

NPI: 1336975077
Provider Name (Legal Business Name): RENEWED POWER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/10/2024
Last Update Date: 05/04/2026
Certification Date: 05/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

615 E 67TH ST
CHICAGO IL
60637-4122
US

IV. Provider business mailing address

1201 S PRAIRIE AVE APT 4304
CHICAGO IL
60605-3552
US

V. Phone/Fax

Practice location:
  • Phone: 708-791-2444
  • Fax:
Mailing address:
  • Phone: 850-251-8547
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QR0400X
TaxonomyRehabilitation Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number
License Number State

VIII. Authorized Official

Name: DR. KEMBERLY DENEEN BRIGGS
Title or Position: CEO
Credential: MD
Phone: 850-251-8547