| Renew Ahava Therapeutic Services Llc | |
|
3340 Poplar Ave Ste 205 Memphis TN 38111-4680 | |
| (901) 513-7084 | |
| Not Available |
| Full Name | Renew Ahava Therapeutic Services Llc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 3340 Poplar Ave Ste 205, Memphis, Tennessee |
| Authorized Official Name and Position | Carmen Gray (OWNER) |
| Authorized Official Contact | 9015137084 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Renew Ahava Therapeutic Services Llc 3340 Poplar Ave Ste 205 Memphis TN 38111-4680 Ph: () - | Renew Ahava Therapeutic Services Llc 3340 Poplar Ave Ste 205 Memphis TN 38111-4680 Ph: (901) 513-7084 |
| NPI Number | 1669123998 |
|---|---|
| Provider Enumeration Date | 01/18/2022 |
| Last Update Date | 01/18/2022 |
| Certification Date | 01/18/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669123998 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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