| Renew Therapy Llc | |
|
1322 W Verbena Dr Meridian ID 83642-1238 | |
| (208) 559-6197 | |
| Not Available |
| Full Name | Renew Therapy Llc |
|---|---|
| Speciality | Social Worker |
| Location | 1322 W Verbena Dr, Meridian, Idaho |
| Authorized Official Name and Position | Joshua Randall Grade (OWNER/ THERAPIST) |
| Authorized Official Contact | 2085596197 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Renew Therapy Llc 1322 W Verbena Dr Meridian ID 83642-1238 Ph: (208) 559-6197 | Renew Therapy Llc 1322 W Verbena Dr Meridian ID 83642-1238 Ph: (208) 559-6197 |
| NPI Number | 1235808528 |
|---|---|
| Provider Enumeration Date | 09/09/2021 |
| Last Update Date | 09/09/2021 |
| Certification Date | 09/09/2021 |
| Medicare PECOS PAC ID | 4880047018 |
|---|---|
| Medicare Enrollment ID | O20240124002233 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235808528 | NPI | - | NPPES |
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