RE-NEW LIFE (NPI# 1740486711) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1740486711 |
| Entity Type | Organization |
| Organization Name | RE-NEW LIFE |
| Practice Address |
33204 E. R.d. Mize Road Grain Valley MO 64029 |
| Practice Telephone | 8164433311 |
| Practice Fax Number | 8164433311 |
| Mailing Telephone | 8164433311 |
| Mailing Fax Number | 8164433311 |
| Enumeration Date | 2007-06-26 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MR. CHARLES P NEELY (CEO) |
| Authorized Official Telephone | 8164433311 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
Behavioral Health & Social Service Providers |
| Street Address |
33204 E. R.D. MIZE ROAD |
| City | GRAIN VALLEY |
| State | MO |
| Zip Code | 64029 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003324542 | Quad/med, LLC | Clinic/Center | 2015 Ne Jefferson Street, Grain Valley, MO 64029 | 2018-01-18 |
| 1336655299 | Cosentino Enterprises Inc | Pharmacy | 1191 Ne Mcquerry Road, Grain Valley, MO 64029 | 2017-12-14 |
| 1427238922 | Tracy Dee Dryer | Pharmacist | 301 Sw Eagle's Parkway, Grain Valley, MO 64029 | 2007-11-13 |
| 1184822736 | Center for The Developmentally Disabled | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1800 Nw Duncan Rd, Grain Valley, MO 64029 | 2007-07-05 |
| 1891822524 | Julia Rachele Loecker | Dentist | 1424 Sw Eagles Parkway, Grain Valley, MO 64029 | 2007-02-28 |
| 1578667192 | Bds Pharmaceutical Inc | Pharmacy | 1400 Sw Eagles Parkway, Grain Valley, MO 64029 | 2006-09-12 |
| 1376575480 | Kurt Frederick Hanneman | Dentist | 655 R.d. Mize Road, Grain Valley, MO 64029 | 2006-07-07 |
| 1144832569 | Crosetti Health and Wellness | Pharmacy | 510 N Main St, Grain Valley, MO 64029 | 2020-08-18 |
| 1528273471 | Katrina Marie Tarpenning | Pharmacist | 1400 Sw Eagles Pkwy, Grain Valley, MO 64029 | 2007-05-14 |
| 1437183001 | Elizabeth A Ward | Dentist | 655 R.d. Mize Road, Grain Valley, MO 64029 | 2006-07-10 |
| Find all providers in zip 64029 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457950511 | Gene Martino | Counselor | 1750 S Brentwood Blvd Ste 302, Saint Louis, MO 63144-1339 | 2020-10-20 |
| 1255951398 | Jennifer Dayle King Brogan | Counselor | 1157 Telegraph Rd, Arnold, MO 63010-4060 | 2020-04-18 |
| 1851937676 | Elizabeth Lawton | Counselor | Elizabeth Lawton, 4220 North Grand Boulevard, Saint Louis, MO 63107 | 2019-11-27 |
| 1467008599 | The Brook Wellness Center | Counselor | 895 State Highway 248 Ste C, Branson, MO 65616-4013 | 2019-08-14 |
| 1437719879 | Rejuvenating Counseling Services | Counselor | 9191 W Florissant Ave Ste 206, Saint Louis, MO 63136-1424 | 2019-06-18 |
| 1467915645 | Plan Your Recovery, LLC | Counselor | 9890 Clayton Rd Ste 132, Saint Louis, MO 63124-1685 | 2019-04-13 |
| 1023572534 | Foundation Recovery Center | Counselor | 2301 Frederick Ave Ste 6, Saint Joseph, MO 64506-2637 | 2019-01-29 |
| 1992278139 | Fancilla Adams | Counselor | 925 State Highway V V, Kennett, MO 63857 | 2019-01-10 |
| 1841769908 | Bernard Godfrey Jr. | Counselor | 3966 Max Weich Pl, Florissant, MO 63033-6768 | 2018-11-19 |
| 1356816631 | Patrick P Pruitt | Counselor | 600 W 39th St, Kansas City, MO 64111-2910 | 2018-10-12 |
| Find all providers with the same taxonomy | ||||
| City | GRAIN VALLEY |
| Zip Code | 64029 |
Please comment or provide details below to improve the information on RE-NEW LIFE.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.