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General NPI Number Information
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NPI Number | 1336975077
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Entity Type | Organization
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Legal Business Name | RENEWED POWER INC
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Dates
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Enumeration Date | 09/10/2024
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Last Update Date | 09/10/2024
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Provider Practice Location Address
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Address Line | 621 E 67TH ST
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City | CHICAGO
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State | IL
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Zip | 60637-4122
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Country | US
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Telephone | 708-791-2444
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Fax |
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Provider Business Mailing Address
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Address Line | 1201 S PRAIRIE AVE APT 4304
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City | CHICAGO
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State | IL
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Zip | 60605-3552
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Country | US
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Telephone | 850-251-8547
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DR. KEMBERLY DENEEN BRIGGS
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Credential | MD
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Telephone | 850-251-8547
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 324500000X
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Taxonomy Name | Substance Abuse Rehabilitation Facility
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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 | 261QR0400X
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Taxonomy Name | Rehabilitation Clinic/Center
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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 | 261QR0405X
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Taxonomy Name | Substance Use Disorder Rehabilitation Clinic/Center
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License Number |
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License Number State |
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