Provider Demographics
NPI:1902621196
Name:RENEWAL MENTAL HEALTH COUNSELING
Entity type:Organization
Organization Name:RENEWAL MENTAL HEALTH COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:BRENDA
Authorized Official - Middle Name:JOYCE
Authorized Official - Last Name:RAHN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:715-595-3714
Mailing Address - Street 1:PO BOX 251
Mailing Address - Street 2:
Mailing Address - City:HOLCOMBE
Mailing Address - State:WI
Mailing Address - Zip Code:54745-0251
Mailing Address - Country:US
Mailing Address - Phone:715-595-3714
Mailing Address - Fax:
Practice Address - Street 1:930 GALLOWAY ST STE 101
Practice Address - Street 2:
Practice Address - City:EAU CLAIRE
Practice Address - State:WI
Practice Address - Zip Code:54703-3913
Practice Address - Country:US
Practice Address - Phone:715-595-3714
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-21
Last Update Date:2024-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health