Renewed Mental Health Llc | |
212 1/2 W 5th St Suite 212 Joplin MO 64801-2501 | |
(417) 626-0212 | |
(888) 977-3363 |
Full Name | Renewed Mental Health Llc |
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Speciality | Community/Behavioral Health |
Location | 212 1/2 W 5th St, Joplin, Missouri |
Authorized Official Name and Position | Scotty J Scott (OWNER) |
Authorized Official Contact | 4176260212 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Renewed Mental Health Llc 212 1/2 W 5th St Suite 212 Joplin MO 64801-2501 Ph: (417) 626-0212 | Renewed Mental Health Llc 212 1/2 W 5th St Suite 212 Joplin MO 64801-2501 Ph: (417) 626-0212 |
NPI Number | 1871991653 |
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Provider Enumeration Date | 12/10/2014 |
Last Update Date | 12/10/2014 |
Medicare PECOS PAC ID | 7012213853 |
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Medicare Enrollment ID | O20160304000653 |
Identifier | Type | State | Issuer |
---|---|---|---|
1871991653 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
251S00000X | Community/behavioral Health | 2003023379 (Missouri) | Primary |
Provider Name | Kim Wright |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1427032085 PECOS PAC ID: 2163458514 Enrollment ID: I20050718000005 |
Provider Name | Angela Jean Fenske |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1326270257 PECOS PAC ID: 6800192642 Enrollment ID: I20160304000767 |
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