Renew Counseling Services, LLC
Counselor, Mental Health in Waterloo, IA. Organization (NPI-2).
NPI number1760617138
StatusActive
Last updated in NPPESMay 28, 2009
Details
- NPI
- 1760617138
- Entity type
- Organization (NPI-2)
- Legal business name
- Renew Counseling Services, LLC
- Organization subpart
- No
- Enumeration date
- May 28, 2009
- Last updated
- May 28, 2009
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101YM0800X | Counselor, Mental Health | 00975 | IA | Yes |
Practice location
3356 Kimball AveSuite 3
Waterloo, IA 50702-5700
Phone 319-464-2940
Mailing address
3356 Kimball AveSuite 3
Waterloo, IA 50702-5700
Phone 319-464-2940
Authorized official
Bruce Alan Gregory
Owner
3194642940
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