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General NPI Number Information
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NPI Number | 1811706922
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Entity Type | Organization
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Legal Business Name | RENEW RECOVERY LLC
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Dates
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Enumeration Date | 01/03/2025
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Last Update Date | 10/30/2025
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Provider Practice Location Address
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Address Line | 1157 ROCKSIDE RD # B2
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City | PARMA
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State | OH
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Zip | 44134-2767
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Country | US
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Telephone | 440-628-5030
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Fax | 440-848-8954
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Provider Business Mailing Address
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Address Line | 1157 ROCKSIDE RD
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City | PARMA
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State | OH
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Zip | 44134-2767
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Country | US
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Telephone | 440-628-5030
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Fax | 440-848-8954
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Authorized Official
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Title or Position | TAX ID OWNER
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Name | RACHEL PETRICK
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Credential | CNP
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Telephone | 440-879-1258
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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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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