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General NPI Number Information
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NPI Number | 1215744628
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Entity Type | Organization
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Legal Business Name | RENEW BEHAVIORAL HEALTH
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Dates
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Enumeration Date | 12/18/2024
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Last Update Date | 12/18/2024
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Provider Practice Location Address
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Address Line | 23611 CHAGRIN BLVD
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City | BEACHWOOD
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State | OH
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Zip | 44122-5540
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Country | US
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Telephone | 888-442-2323
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Fax |
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Provider Business Mailing Address
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Address Line | 71 HALLEY DR
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City | POMONA
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State | NY
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Zip | 10970-2108
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Country | US
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Telephone | 718-213-3530
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Fax |
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Authorized Official
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Title or Position | COMPLIANCE OFFICER
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Name | MRS. LEAH NEIMAN
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Credential |
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Telephone | 216-373-3122
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174200000X
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Taxonomy Name | Meals Provider
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 177F00000X
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Taxonomy Name | Lodging Provider
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License Number |
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License Number State |
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