Provider Demographics
NPI:1285471383
Name:RENEWED OUTLOOK HOLISTIC MENTAL HEALTH AND WELLNESS LLC
Entity type:Organization
Organization Name:RENEWED OUTLOOK HOLISTIC MENTAL HEALTH AND WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:MARINO
Authorized Official - Suffix:
Authorized Official - Credentials:CRNP
Authorized Official - Phone:724-302-5969
Mailing Address - Street 1:PO BOX 10526
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15235-0526
Mailing Address - Country:US
Mailing Address - Phone:724-302-5969
Mailing Address - Fax:724-204-1946
Practice Address - Street 1:130 N. MCKEAN ST.
Practice Address - Street 2:SUITE 204
Practice Address - City:KITTANNING
Practice Address - State:PA
Practice Address - Zip Code:16201
Practice Address - Country:US
Practice Address - Phone:724-302-5969
Practice Address - Fax:724-204-1946
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-15
Last Update Date:2024-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty