| Renew Psychiatric Services | |
|
400 Central Ave Nw Ste 1400 Orange City IA 51041-1331 | |
| (712) 230-3012 | |
| Not Available |
| Full Name | Renew Psychiatric Services |
|---|---|
| Speciality | Clinic/Center |
| Location | 400 Central Ave Nw Ste 1400, Orange City, Iowa |
| Authorized Official Name and Position | Heather M. Glasser (OWNER) |
| Authorized Official Contact | 7122303012 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Renew Psychiatric Services 400 Central Ave Nw Ste 1400 Orange City IA 51041-1331 Ph: () - | Renew Psychiatric Services 400 Central Ave Nw Ste 1400 Orange City IA 51041-1331 Ph: (712) 230-3012 |
| NPI Number | 1720740772 |
|---|---|
| Provider Enumeration Date | 10/07/2021 |
| Last Update Date | 10/07/2021 |
| Certification Date | 10/07/2021 |
| Medicare PECOS PAC ID | 9931595527 |
|---|---|
| Medicare Enrollment ID | O20220407001178 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720740772 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Heather M. Glasser |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750051363 PECOS PAC ID: 0840686432 Enrollment ID: I20220407001258 |
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