# RENEWED VISION COUNSELING AND DEVELOPMENTAL DISABILITY CENTER PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1174122170
- **Authorized official:** CHRISTOPHER MARSHALL PLMHP (OWNER)
- **Authorized official phone:** (531) 876-7455

## Contact information

- **Practice address:** 4610 S. 133RD ST, SUITE 106, OMAHA, NE 68137-1133
- **Practice address phone:** (402) 275-6413
- **Mailing address:** 4642 S. 132ND ST, OMAHA, NE 68137-1764
- **Mailing address phone:** (531) 876-7455

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YM0800X | Mental Health Counselor | — | NULL | Yes |
| 101YM0800X | Mental Health Counselor | — | — | Yes |
| 251C00000X | Developmentally Disabled Services Day Training Agency | — | NULL | — |
| 261QR0405X | Substance Use Disorder Rehabilitation Clinic/Center | — | NULL | — |
| 320900000X | Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility | — | NULL | — |

## Other

- **Enumeration date:** 10/21/2020
- **Last updated:** 02/26/2025