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General NPI Number Information
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NPI Number | 1043987266
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Entity Type | Organization
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Legal Business Name | RENEWED LIFE THERAPY
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Dates
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Enumeration Date | 08/25/2021
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Last Update Date | 09/13/2021
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Provider Practice Location Address
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Address Line | 1515 E SILVER SPRINGS BLVD # 147-2
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City | OCALA
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State | FL
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Zip | 34470-6831
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Country | US
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Telephone | 352-875-3029
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Fax | 352-877-2493
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Provider Business Mailing Address
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Address Line | 4572 SW 44TH CT
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City | OCALA
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State | FL
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Zip | 34474-4345
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Country | US
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Telephone | 352-875-3029
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | KIMBERLY A SINDY
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Credential | LCSW
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Telephone | 352-875-3029
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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