RENEST RECOVERY SUPPORT SERVICES OF ILLINOIS NPI 1093307266

NPI Information

NPI: 1093307266
Provider Name: RENEST RECOVERY SUPPORT SERVICES OF ILLINOIS

Doing Business As: RENEST RECOVERY SUPPORT SERVICE ROCKFORD LLC

Classification: Clinic/Center - 261QM0850X
Entity Type: Organization

Specialization: Adult Mental Health

Address:
910 2ND AVE
ROCKFORD, IL
ZIP 61104
Phone: (270) 839-6743
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RENEST RECOVERY SUPPORT SERVICES OF ILLINOIS is an adult mental health clinic center in Rockford, IL. The provider is an entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in adults. RENEST RECOVERY SUPPORT SERVICES OF ILLINOIS NPI is 1093307266. The provider is registered as an organization entity type.
The provider Is Doing Business As Renest Recovery Support Service Rockford Llc.

The provider's business location address is:

910 2ND AVE
ROCKFORD, IL
ZIP 61104-162
Phone: (270) 839-6743

The provider's authorized official is Christina Nicole Hobson .
The authorized official title is Authorized Official, Human Resource and has the following contact phone number (270) 839-6743.

The enumeration date for this NPI number is 2/9/2021 and was last updated on 11/23/2021.

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
1	261QM0855X	Clinic/Center	Adolescent and Children Mental Health			No
2	261QM0850X	Clinic/Center	Adult Mental Health			Yes

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: 11/14/2023

NPI Synchronization or Removal

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