| Renew 4 Life Llc | |
|
240 S 5th W Ste E Rigby ID 83442-1476 | |
| (208) 520-1690 | |
| Not Available |
| Full Name | Renew 4 Life Llc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 240 S 5th W Ste E, Rigby, Idaho |
| Authorized Official Name and Position | Christina Dompier (OWNER) |
| Authorized Official Contact | 2085201690 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Renew 4 Life Llc Po Box 475 Ashton ID 83420-0475 Ph: (208) 520-1690 | Renew 4 Life Llc 240 S 5th W Ste E Rigby ID 83442-1476 Ph: (208) 520-1690 |
| NPI Number | 1558681106 |
|---|---|
| Provider Enumeration Date | 06/06/2010 |
| Last Update Date | 06/06/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558681106 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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