| Renewal Room Llc | |
|
38601 Mentor Ave Apt 108 Willoughby OH 44094-8079 | |
| (440) 290-9207 | |
| Not Available |
| Full Name | Renewal Room Llc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 38601 Mentor Ave Apt 108, Willoughby, Ohio |
| Authorized Official Name and Position | Jessica Fisher (OWNER) |
| Authorized Official Contact | 4402909270 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Renewal Room Llc 2722 Erie Ave Ste 219 Cincinnati OH 45208-2154 Ph: (440) 290-9207 | Renewal Room Llc 38601 Mentor Ave Apt 108 Willoughby OH 44094-8079 Ph: (440) 290-9207 |
| NPI Number | 1295560977 |
|---|---|
| Provider Enumeration Date | 09/03/2024 |
| Last Update Date | 09/03/2024 |
| Certification Date | 09/03/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295560977 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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