| Anew Genesis Wellness Inc. | |
|
4205 Quailshire Arch Chesapeake VA 23321-3244 | |
| (757) 761-8686 | |
| Not Available |
| Full Name | Anew Genesis Wellness Inc. |
|---|---|
| Speciality | Social Worker |
| Location | 4205 Quailshire Arch, Chesapeake, Virginia |
| Authorized Official Name and Position | Renata Jamison (CEO) |
| Authorized Official Contact | 7577618686 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Anew Genesis Wellness Inc. 4205 Quailshire Arch Chesapeake VA 23321-3244 Ph: (757) 761-8686 | Anew Genesis Wellness Inc. 4205 Quailshire Arch Chesapeake VA 23321-3244 Ph: (757) 761-8686 |
| NPI Number | 1407478084 |
|---|---|
| Provider Enumeration Date | 05/17/2020 |
| Last Update Date | 05/17/2020 |
| Certification Date | 05/17/2020 |
| Medicare PECOS PAC ID | 0941615736 |
|---|---|
| Medicare Enrollment ID | O20210208002013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407478084 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Renata Jamison |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1043724602 PECOS PAC ID: 5698022234 Enrollment ID: I20180727001084 |
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