Healthcare Provider Details

I. General information

NPI: 1053221408
Provider Name (Legal Business Name): RENEW AND THRIVE THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/09/2026
Last Update Date: 09/09/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

305 S 11TH ST STE 100
SEWARD NE
68434-2312
US

IV. Provider business mailing address

3456 BRANCHED OAK RD
STAPLEHURST NE
68439-8834
US

V. Phone/Fax

Practice location:
  • Phone: 402-523-1555
  • Fax:
Mailing address:
  • Phone: 530-330-0581
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State

VIII. Authorized Official

Name: RAEGAN K HAIN
Title or Position: OCCUPATIONAL THERAPIST/OWNER
Credential: MS, OT/L
Phone: 530-330-0581