RENEW PEDIATRIC THERAPY LLC NPI 1043163926

NPI Information

  • NPI: 1043163926
  • Provider Name: RENEW PEDIATRIC THERAPY LLC
  • Classification: Clinic/Center - 261QH0700X
  • Specialization: Hearing and Speech
  • Entity Type: Organization
  • Address: 21995 FINLEY CT N
    FOREST LAKE, MN
    ZIP 55025
  • Phone: (480) 529-0269

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NPI Details

RENEW PEDIATRIC THERAPY LLC is a hearing and speech clinic center in Forest Lake, MN. The provider is an entity, facility, or distinct part of a facility providing diagnostic, treatment, prescriptive, and therapy services related to congenital and acquired conditions and diseases that affect hearing capacity and speech ability. RENEW PEDIATRIC THERAPY LLC NPI is 1043163926. The provider is registered as an organization entity type.

The provider's business location address is:

21995 FINLEY CT N
FOREST LAKE, MN
ZIP 55025-779
Phone: (480) 529-0269
Fax: (651) 243-0305

The provider's authorized official is Ellen E Van Tassel .
The authorized official title is Owner and has the following contact phone number (480) 529-0269.

The enumeration date for this NPI number is 2/19/2026 and was last updated on 2/19/2026.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QH0700XClinic/CenterHearing and SpeechYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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