Provider Demographics
NPI:1336975077
Name:RENEWED POWER INC
Entity type:Organization
Organization Name:RENEWED POWER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:KEMBERLY
Authorized Official - Middle Name:DENEEN
Authorized Official - Last Name:BRIGGS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:850-251-8547
Mailing Address - Street 1:1201 S PRAIRIE AVE APT 4304
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60605-3552
Mailing Address - Country:US
Mailing Address - Phone:850-251-8547
Mailing Address - Fax:
Practice Address - Street 1:621 E 67TH ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60637-4122
Practice Address - Country:US
Practice Address - Phone:708-791-2444
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:RENEWED POWER INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-09-10
Last Update Date:2024-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder
No251S00000XAgenciesCommunity/Behavioral Health
No261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation
No324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility