RENEWED LIFE COUNSELING LLC NPI 1811452188

NPI Information

NPI: 1811452188
Provider Name: RENEWED LIFE COUNSELING, LLC
Classification: Substance Abuse Rehabilitation Facility - 324500000X
Entity Type: Organization
Doing Business As: RENEWED LIFE COUNSELING SERVICES
Address: 10026 UNIVERSITY AVE NW STE 103
COON RAPIDS, MN
ZIP 55448
Phone: (612) 636-9677

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NPI Details

RENEWED LIFE COUNSELING, LLC is a substance abuse rehabilitation facility in Coon Rapids, MN. The provider is a facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances. RENEWED LIFE COUNSELING, LLC NPI is 1811452188. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Renewed Life Counseling Services.

The provider's business location address is:

10026 UNIVERSITY AVE NW STE 103
COON RAPIDS, MN
ZIP 55448-213
Phone: (612) 636-9677

The provider's authorized official is Nikisha Lynnette Simmons-maclin .
The authorized official title is Executive Director and has the following contact phone number (612) 636-9677.

The enumeration date for this NPI number is 1/31/2019 and was last updated on 1/31/2019.

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	101YA0400X	Counselor	Addiction (Substance Use Disorder)			No
2	324500000X	Substance Abuse Rehabilitation Facility				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	1098948	OTHER	MINNESOTA	MINNESOTA DEPARTMENT OF HUMAN SERVICES

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: 3/30/2025

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