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General NPI Number Information
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NPI Number | 1255225389
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Entity Type | Organization
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Legal Business Name | REDEFINE PSYCHIATRY, LLC
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Dates
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Enumeration Date | 06/04/2025
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Last Update Date | 06/04/2025
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Provider Practice Location Address
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Address Line | 1370 NW 114TH ST STE 109
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City | CLIVE
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State | IA
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Zip | 50325-7011
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Country | US
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Telephone | 515-316-6736
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Fax | 515-495-7257
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Provider Business Mailing Address
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Address Line | 1370 NW 114TH ST STE 109
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City | CLIVE
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State | IA
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Zip | 50325-7011
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Country | US
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Telephone | 515-316-6736
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Fax | 515-495-7257
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Authorized Official
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Title or Position | ARNP/OWNER
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Name | ANA VALENCIA
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Credential |
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Telephone | 515-316-6736
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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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