| Renew Life Concepts, Llc | |
|
5868 E 71st St Ste E-630 Indianapolis IN 46220-4075 | |
| (317) 835-3435 | |
| Not Available |
| Full Name | Renew Life Concepts, Llc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 5868 E 71st St Ste E-630, Indianapolis, Indiana |
| Authorized Official Name and Position | Adriaka Jackson (MANAGER) |
| Authorized Official Contact | 3178353435 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Renew Life Concepts, Llc 5868 E 71st St Ste E-630 Indianapolis IN 46220-4075 Ph: (317) 835-3435 | Renew Life Concepts, Llc 5868 E 71st St Ste E-630 Indianapolis IN 46220-4075 Ph: (317) 835-3435 |
| NPI Number | 1528602257 |
|---|---|
| Provider Enumeration Date | 11/06/2019 |
| Last Update Date | 04/26/2023 |
| Certification Date | 04/26/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528602257 | NPI | - | NPPES |
| 8973191013 | Medicaid | IN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | (* (Not Available)) | Secondary |
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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