REMEDIES RENEWING LIVES NPI 1558587824

NPI Information

NPI: 1558587824
Provider Name: REMEDIES RENEWING LIVES
Classification: Clinic/Center - 261QR0405X
Entity Type: Organization

Specialization: Rehabilitation, Substance Use Disorder

Address:
215 EASTON PKWY
ROCKFORD, IL
ZIP 61108
Phone: (815) 962-0871
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REMEDIES RENEWING LIVES is a rehabilitation and substance use disorder clinic center in Rockford, IL. REMEDIES RENEWING LIVES NPI is 1558587824. The provider is registered as an organization entity type.

The provider's business location address is:

215 EASTON PKWY
ROCKFORD, IL
ZIP 61108
Phone: (815) 962-0871
Fax: (815) 962-7895

The provider's authorized official is Kathy S. Branning .
The authorized official title is Vp Of Marketing/fund Development and has the following contact phone number (815) 966-1285.

The enumeration date for this NPI number is 4/17/2007 and was last updated on 7/29/2021.

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	261QM2800X	Clinic/Center	Methadone	A-0559-0005-A	ILLINOIS	No
2	261QR0405X	Clinic/Center	Rehabilitation, Substance Use Disorder	A-0559-0005--A	ILLINOIS	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	=========	MEDICAID	ILLINOIS

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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